Pancreatic sarcomatoid carcinoma is an extremely rare malignant tumor.The clinical data and computed tomography images of 8 patients with pancreatic sarcomatoid carcinoma who were admitted to the Subei People's Hospital from March 2001 to January 2013 were retrospectively analyzed.The results of computed tomography showed that 8 tumors were cystic and solid,showing exophytic growth.Two tumors were located in the pancreatic head,1 in the pancratic neck,3 in the body of pancreas,and 2 in the tail of the pancreas.The shape of the tumors were round or ellipse,and the mean tumor diameter was (7.2 ± 1.8)cm (range,6.3-9.6 cm).The plain scan of computed tomography showed that the attenuation of the tumors was mild hyperdense (7 cases) or equal to pancreatic tissue (1 case).Tumors were solid with cystic components,and no hemorrhage within the tumor was detected.Small calcification nodule wasdetected in 1 case.The enhanced scan of computed tomography showed that the enhancement of the tumor was moderate; the enhancement of the tumor was higher than that of normal pancreatic parenchyma during venous phase and delayed phase,while lower than that of normal pancreatic parenchyma on arterial phase; the enhancement of tumors was significantly lower than that of aorta during all the enhanced phases.All the tumors had complete capsule,and abnormal enhancement of the capsule was not detected.Three tumors had peripancreatic lymphadenectasis,2 had infiltration of splenic artery,2 had infiltration of splenic flexure of colon and 1 had infiltration of duodenal serosa or muscle.Familiarity with the imaging features of the pancreatic sarcomatoid carcinoma can help surgeons to make a suggestive diagnosis.

Objective To compare the efficacy of spectral CT imaging and 64 slice CT in assessment of carotid artery atherosclerotic plaque.Methods Thirty-eight patients with carotid plaque were detected retrospectively in this study (plaque,n=46) by using spectral CT.The composition of atherosclerotic plaque was measured by iodine-based images,lipid-based images with spectral CT imaging.Intraplaque hemorrhae,lipid components were also evaluated on spectral CT imaging and compared with pathology and specimen.Statistical comparison was performed with the Kappa value,independent-sample t test and exact test.Results The degree of carotid artery stenosis was (63.3 ±3.1)％ on spectral CT imaging whereas (61.6 ± 3.8) ％ on 64 slice CT.Two imaging modalities were in good consistency in evaluation of the degree of stenosis (Kappa=0.993,P＜0.01).There was no statistical difference in detecting fibrous cap rupture on spectral CT imaging and 64 slice CT (12 plaques vs 11 plaques,respectively,P＞0.05).Furthermore,spectral CT imaging showed 11 plaques within intraplaque hemorrhage,however,no case was found on 64 slice CT (P＜0.05).The plaque iodine concentration were (6.365 ± 1.937) and (1.573 ±0.776) mg/cm3 with or without internal hemorrhage(t=16.39,P＜0.05).Spectral CT imaging showed 9 plaques within intraplaque liquid whereas only 2 plaques showed intraplaque liquid on 64 slice CT (P＜0.05).Twenty-eight plaques within calcification in the plaque were found on spectrl CT imaging and 27 on 64 slice CT(P＞0.05).Conclusion Spectral CT imaging is a reliable tool in detecting intraplaque hemor-rhage and liquid component.

BACKGROUND:Removing the posterior ligamentous complexes during posterior lumbar interbody fusion (PLIF) may influence motion and load bearing characteristics of the adjacent segments,contributing to the postoperative instability at the adjacent segment,which is one of the important factors for adjacent segment degeneration.OBJECTIVE:To evaluate the clinical effectiveness of the PLIF plus screw implantation preserving posterior ligamentous complexes under microscope.METHODS:Thirty-six patients with single-level lumbar degenerative disease were enrolled,which were allotted to experimental (n=17) and control (n=1 9) groups,followed by treated with PLIF plus screw implantation preserving posterior ligamentous complexes,and traditional PLIF plus screw implnatation,respectively.The Visual Analogue Scale scores and Oswestry Dysfunction Index at baseline and postoperative 3 months were assessed.The adjacent segment degeneration was observed through radiology during follow-up.RESULTS AND CONCLUSION:The Visual Analogue Scale and Oswestry Dysfunction Index scores in the two groups were significantly lower than those before treatment (P ＜ 0.01),and the postoperative scores in the experimental group were significantly lower than those in the control group (P ＜ 0.01).The adjacent segment degeneration occurred in two cases in the experimental group and 8 cases in the control group during follow-up.Radiology revealed that the internal fixative was stable,none of screw loosening,rupture or pullout.These results suggest that PLIF plus screw implantation with posterior ligamentous complexes can effectively relieve the pain and dysfunction in the lumbar degenerative patients,and reduce the incidence of adjacent segment degeneration.

Objective To investigate the diagnostic value of computed tomography,X ray enterography and digestive endoscopy for intestinal Crohn's disease in active and chronic phase.Methods The clinical data of 39 patients with Crohn's disease who were admitted to the Subei People's Hospital from June 2008 to August 2011 were retrospectively analyzed.All patients were divided into the active phase group (28 patients) and the chronic phase group (11 patients).The results of computed tomography,X ray enterography and digestive endoscopy of the 2 groups were compared.The accuracy of the 3 diagnostic methods was assessed by consulting the operative findings.The enumeration data were analyzed using the chi-square test.Results The incidences of intestinal wall stratification,intesitnal edema strap,severe enhancement,ulcers,intestinal stenosis,intestinal fistula,phlegmon,swollen lymph nodes and comb sign in patients with active phase of Crohn's disease were significantly higher than those with chronic phase of Crohn's disease (x2 =10.700,3.954,22.025,7.661,10.700,7.661,6.810,7.661,4.592,P＜0.05).The incidences of intestinal wall thickening,intramural fat,mild enhancement,unenhancement,inflammatory polyps,abscesses and inflammatory masses in patients with chronic phase of Crohn's disease were significantly higher than those with active phase of Chrohn's disease (x2=17.475,11.345,18.050,5.366,22.856,12.662,5.846,P ＜ 0.05).Computed tomography was effective in detecting intestinal wall thickening and extraintestinal complications of Crohn's disease,but it was difficult in demonstrating ulcers and inflammatory polyps.X ray enterography and digestive endoscopy were effective in detecting ulcers and inflammatory polyps,but they were difficult in detecting intestinal wall thickening and extraintestinal complications of Crohn's disease.Conclusion Computed tomography combined with X ray enterography and digestive endoscopy is helpful in demonstrating the presentations of Crohn's disease in active and chronic phase.

Objective To investigate clinical,endoscopic and CT characteristics in Crohn's disease (CD),intestinal tuberculosis(ITB) and primary small intestinal lymphoma (PSIL).Methods In this study,39 cases of CD,24 cases of ITB and 23 cases of PSIL were retrospectively analyzed.Clinical and CT data were collected in all patients,23 CD cases,20 ITB cases and 20 PSIL cases underwent endoscopic exam.Chi-square tests or analysis of variance were used to evaluate and differentiate characteristics.Results Diarrhea,perianal disease,intestinal obstruction occurred significantly more in CD than in ITB and PSIL (x2 =10.134,6.769,8.000,P ＜ 0.05).Febrility,night sweating,pulmonary tuberculosis and ascites occurred more in ITB than in CD and PSIL (x2 =25.696,19.194,35.133,P ＜0.05).Abdominal mass,hematochezia and enterobrosis occurred more in PSIL than in CD and ITB (x2 =19.562,17.708,12.647,P＜0.05).Longitudinal ulcer,cobblestone sign were found more in CD than in ITB and PSIL(x2 =6.283,11.592,P ＜ 0.05).Transverse ulcer and rodent ulcer were found more in ITB than in CD and PSIL(x2 =15.633,19.686,P ＜ 0.05),but lump eminentia were found more in PSIL than in CD and ITB(x2 =26.120,P ＜0.05).Layering thickening,mural gas,fat,edema,enteric cavity stenosis,abscess were discovered more in CD than in ITB and PSIL (x2 =17.472,10.346,7.773,6.867,16.325,10.994,P＜0.05),single layer thickening and hollow lymph nodes were discovered more in ITB than in CD and PSIL(x2 =17.997,12.475,P ＜ 0.05).Multi segmental lesions was discovered more in CD and ITB than in PSIL (x2 =28.460,P ＜ 0.05),while single segmental lesions,mural single eccentric layer thickening and intussusceptions were discovered more in PSIL than in CD and PSIL (x2 =28.460,P ＜0.05).The intestinal wall thickening and lymph nodes enlargement in ITB and PSIL were higher than the CD (F =8.661,7.166,P ＜ 0.05),while the intestinal wall enhancement at CT imaging in PSIL was lower than CD and ITB (F =10.179,P ＜ 0.05).Conclusions Comprehensive analysis made on clinical,endoscopic and CT features of CD,ITB and PSIL may facilitate correct diagnosis.

Objective To study the X-ray imaging characteristics of gouty arthritis. Methods The X-ray plates from gouty arthritis were analyzed. Results The gouty arthritis usually occurred in the first metatarsophalangeal joint. The X-ray findings were dissymmetric swellings of soft tissue,bony erosion defect with sharp and hard edge,narrowed joint space and irregular articular surface,emergence of fiber stiffness,even joint malformations and sublimation or dislocation, associated with hyperosteogeny and nearby osteoporosis. Conclusion Diversification was presented in X-ray findings of gouty arthritis, which could be easily confused with other single or multiple bone joint diseases. As a result, accurate diagnosis should be based on careful analysis about X-ray findings.

Objective To establish a Hr mutant knockout mouse model to study the function of Hr gene.Methods Transcription activator-like effector nucleases ( TALENs) technique was used to disrupt the mouse Hr locus,creating heritable mutations that eliminate Hr function to explore the effects of Hr on hair development and provide a good model to study the function of Hr gene.The phenotype of Hr -/- mice was observed after birth and skin histology of the transgenic mice was studied by light microscopy.Results It was shown that a F0 mouse with the 2 -bp deletion in Hr gene ranging from 86 to 87 base pairs was obtained.The male mice with clear deletion of the Hr fragment and with obvious frame shifting were mated with wild-type female mice, and F1 mice were achieved.The heterozygous males mated with females to generate the F2 homozygous mice.The first hair coat of Hr-/- mice developed normally.Beginning from 14 days after birth, however, there was a rapid hair loss.The mices were completely hairless except for a few vibrissae at 30 days. Histologically, two characteristic structures appeared, the utriculus and dermal cyst.Conclusions The results suggest that Hr -/- mice are successfully created using TALENs, and Hr is important for regulating hair development, which could explain at least in part the hair loss and be applied to study the mechanism of hair growth and development disorder.

Objective To investigate the effects of negative pressure wound therapy (NPWT) on the expression of EDA+ FN in granulation tissues of human diabetic foot wounds.Methods Forty patients with diabetic foot wounds fitting the inclusion criteria,admitted from Jan.2014 to Jun.2016,were randomly and equally apportioned to receive either NPWT or conventional gauze therapy (control) for 14 days.Granulated tissue biopsies were collected before (0 day) and after (14 day) treatment in both groups.All biopsies were subdivided into two parts.One part was preserved in 4％ paraformaldehyde for immunocytochemical staining of EDA+FN,and the other part was stored at-80 ℃ for Western blotting and PCR analysis of EDA+FN.Results The immunohistochemical analysis revealed that the mean area density of EDA+ FN increased in both NPWT group and control group at day 14 relative to day 0,but the change value of mean area density was higher in NPWT group than in control group (P＜0.01).Western blotting showed that the relative protein levels of EDA+FN increased in both NPWT group and control group at day 14 relative to day 0,but the change value of relative protein levels of EDA+FN was higher in NPWT group than in control group (P＜0.01).The real time PCR analysis demonstrated that the relative mRNA levels of EDA+ FN increased in both NPWT group and control group at day 14 relative to day 0,but the change value of relative mRNA levels of EDA+ FN was higher in NPWT group than in control group (P＜0.01).The results demonstrated the higher protein and mRNA levels of EDA+FN in NPWT group than that in control group.Conclusion NPWT obviously enhances EDA+FN expression in granulation tissue of diabetic foot wound,as a result promotes wound healing.

Objective To investigate the MSCT features of the renal cell carcinoma associated with XP11.2 translocation-TFE gene fusion ( XP11.2-TFE Ca).Methods The MSCT features of XP11.2-TFE Ca in six patients were retrospectively analyzed,which were confirmed by postoperative histopathology.All the tumor features were recorded and compared to the histopathological findings.Variance test analysis was performed to compare the CT values among tumor,normal renal cortex and normal renal medulla.Results XP11.2-TFE Ca appeared as a solitary lesion in all the 6 patients,which limited in the medulla in 3 patients and infiltrated both medulla and renal pelvis in other 3 patients.The tumor diameter ranged from 3.8 to 5.2 cm [mean diameter,(4.2 ± 1.3) cm],And the adjacent renal cortex was compressed or involved.Four lesions were oval,2 lesions were irregular shape.Tumor capsule showed in all lesions in the six patients.Cystic component and retroperitoneal lymph node metastasis respectively occurred in one patient.In all lesions,calcification was not detected.On unenhanced CT scan phase,the CT values of the normal cortex,normal medulla and XP11.2-TFE Ca were (42 ±5),(38 ±4) and (48 ±4) HU respectively,with no significant statistical difference ( F =1.267,P ＞ 0.05 ) ; on cortical nephrographic phase after contrast injection,they were ( 174 ± 10 ),( 72 ± 8 ) and ( 100 ± 9) HU respectively,with significant statistical difference among the three groups (F =6.588,P ＜ 0.01) ; on parenchymal nephrographic phase,they were (207 + 12),(109 +8) and ( 121± 11) HU respectively,with significant statistical difference (F =7.172,P＜0.01) ; and on the excretory phase,they were (148 ± 12),(67 ±8) and (83 ±7) HU respectively,with significant statistical difference ( F =2.678,P ＜ 0.05 ).On each phase of contrast-enhanced MSCT scan,the enhancement of XP11.2-TFE Ca was higher than that of the medulla and lower than that of the cortex.Conclusions XP11.2-TFE Ca had some characteristic MSCT features.Comprehensive analysis of its MSCT features may help for improving the diagnosis.

The clinical data,endoscopic and CT findings of 39 patients with Crohn's disease(CD) and 24 patients with intestinal tuberculosis (ITB) were retrospectively reviewed.Diarrhea,hematochezia,perianal disease,intestinal obstruction,occurred more frequently in CD than in ITB (P ＜0.05 or ＜0.01).Night sweating,febrility,pulmonary tuberculosis and ascites were more common in ITB than in CD (P ＜0.01).The endoscopic findings showed that longitudinal ulcer,cobblestone sign,intestinal stricture were detected more often in CD than in ITB (P ＜ 0.05 or ＜ 0.01),but transverse ulcer and rodent ulcer were more frequently found in ITB than in CD (P ＜0.05 or ＜0.01).On the CT imaging mural gas,fat,enteric cavity stenosis and layering thickening were more common in CD than in ITB (P ＜ 0.05 or ＜ 0.01),but mural single layer thickening and hollow lymph nodes were discovered more frequently in ITB than in CD (P ＜ 0.01).The degree of intestinal wall thickening,enhancement and lymph nodes enlargement of ITB were more severe than that of CD (P ＜ 0.01).The clinical manifestations combined with endoscopic and CT finding may improve the differential diagnosis between Crohn's disease and intestinal tuberculosis.