Objective To study the helical CT dual-phase feature of peripheral enhancement in small hepatocellular carcinoma (SHCC) and to evaluate its correlation with the histopathology. Methods The helical CT dual-phase feature of peripheral enhancement in SHCC was analyzed in 17 cases with 18 lesions, all the lesions were confirmed by operation and histopathology. Results In 17 lesions, peripheral enhancement ring of the lesions wasn′t intact, the thickness of peripheral enhancement ring wasn′t uniform, and small nodular enhancement was found inside the peripheral enhancement ring in hepatic arterial phase (HAP). In 1 lesion, the peripheral enhancement ring of the lesion was intact and the thickness of peripheral enhancement ring was uniform in HAP. The density of the peripheral enhancement ring and the small nodular enhancement decreased to hypodense or isodense than the normal liver parenchyma in portal venous phase. Pathologic pattern: 16 lesions were trabecular type and 2 lesions were scirrhous type. The differentiation of the tumor cell was grade I in 2 lesions, grade Ⅱ in 14 lesions, grade Ⅲ in 1 lesion, and grade Ⅳ in 1 lesion, respectively. In 12 lesions, the vessels were richer in the lesion border than that in the lesion center. In 6 lesions, the vessels were less rich in both center and border. In 3 lesions, the pseudo-capsule was showed in the border of the lesion. In 10 lesions, the flecks of necrosis were demonstrated in the border and/or center of the lesion. Conclusion The helical CT dual-phase feature of peripheral enhancement in SHCC is characteristic, and SHCC might be distinguished from other hepatic diseases with peripheral enhancement.

Objective To study the helical CT dual-phase enhancement manifestation of the hypodense small hepatocellular carcinoma, and to evaluate its correlation with the histopathology. Methods The CT signs and its histopathologic changes were analyzed in 25 cases with 27 hypodense lesions in helical CT dual-phase enhancement. All the lesions were confirmed as small hepatocellular carcinoma by operation and histopathology. Results (1) On unenhanced scan, 16 lesions were with obscure borders and 11 lesions were with well-delineated borders. On enhanced scan, only 7 lesions were with obscure borders and the other 20 lesions were with well-delineated borders, and their contours were slightly irregular. (2) On unenhanced scan, 18 lesions showed homogeneous hypodensity and 9 lesions showed heterogeneous hypodensity. On enhanced scan, only 6 lesions showed homogeneous hypodensity and the other 21 lesions showed heterogeneous hypodensity with multiple flecks of more hypodense areas. Conclusion The helical CT dual-phase enhancement characteristic manifestations of hypodense small hepatocellular carcinoma were as follows: the border of the lesion was obscure on unenhanced scan, however the border of the lesion became well-delineated and slightly irregular, and there were multiple flecks of more hypodense areas in the lesions after enhancement. This might be an important character in distinguishing hypodense small hepatocellular carcinoma from other hypodense diseases in the liver.

AIM:To study the effects of progesterone(P4) on the maturation and immunologic function of dendritic cells(DCs) from human peripheral blood.METHODS:Cultured DCs were treated with P4 at doses of 10-7 mol/L and 10-6 mol/L.The morphologic changes were observed under the scanning electronic microscope.The immunophenotypes of DCs in control and treated groups were analyzed by flow cytometry.IL-10 and IL-12 production in culture supernatant was examined by ELISA assay.The capability of the stimulatory activity of the DCs on allogeneic T cells in mixed reaction was tested by incorporation of [3H]-TdR.RESULTS:Compared with control group,cultured DCs in the presence of P4 displayed less dendritic pseudopod,expressed low levels of MHC-II,CD40,CD80 and CD86,and exhibited weakly activity in stimulating the proliferation of allogeneic T cells.Increase in IL-10 production and decrease in IL-12 production were observed.CONCLUSION:P4 exerts negative effect on the maturation and immunologic function in dendritic cells from human peripheral blood.

AIM:To study the roles of bone marrow-derived dendritic cells from donor mouse treated with 17?-estradiol(E2)in immune tolerance induction in skin allograft.METHODS:Bone marrow-derived dendritic cells from C57 mouse as donor were cultured respectively treated with E2(E2 group).BALB/c mouse as recipient received respectively one injection of dendritic cells of E2 group,mature dendritic cell group and immature dendritic cell group intravenously.Skin transplantation was performed in the absence of immunosupression after 7 d.Mice that received PBS were served as control.The time of skin survival was observed after transplantation.Flow cytometry was used to analyze the percentage of CD4+CD25+ T cells in peripheral blood respectively before and after transplantation.RESULTS:Compared with immature dendritic cells and control group,the time of skin survival in E2 group was significantly longer(P

0.05), the percentage of MDC and PDC and the ratio of MDC/PDC at the second (MDC, 0.11%?0.09%; PDC, 0.06%?0.05%; MDC/PDC, 0.76?0.80), third trimester (MDC, 0.12%?0.08%; PDC, 0.07%?0.06%; MDC/PDC, 0.78?0.82) were significantly lower (P

ored carefully.

Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) targeted treatment has been a standard therapy for advanced non-small cell lung cancer (NSCLC), but it is not tolerated well by all patients. In China, some studies have reported that traditional Chinese medicinal herbs (TCMHs) may increase efficacy and reduce toxicity when combined with EGFR-TKI, but outside of China few studies of this kind have been attempted.

Objective To explore the imaging features of external iliac artery-related postpartum hemorrhage, and to discuss its interventional therapy measures. Methods The clinical data and imaging findings of one patient with external iliac artery-related postpartum hemorrhage was retrospectively analyzed. The patient received interventional therapy at the intervention department of Shanxi provincial people ’s hospital. The relevant academic papers published in medical literature were reviewed. The common features of this condition were summarized, and the imaging features and the interventional therapy measures were discussed. Results A total of 4 patients, including authors’ case, with external iliac artery- related postpartum hemorrhage were reported in China. Of the 4 case , right external iliac artery-related postpartum hemorrhage was seen in 2 and bilateral external iliac artery-related postpartum hemorrhage was seen in other two. Embolization therapy of three abnormal branches of deep circumflex iliac artery that participated in the uterine blood supply was carried out. Immediately after the embolization the bleeding stopped. Conclusion For the treatment of postpartum hemorrhage, uterine arterial embolization should be followed by abdominal aorta angiography so as to check the external iliac artery. When recurrent bleeding occurs after uterine arterial embolization, the possibility that the abnormal branches of external iliac artery participates in the uterine blood supply should be considered. In performing the embolization of abnormal branches of external iliac artery, the catheter should be inserted to the distal end of the target vessel. Under DSA monitoring the embolic agent should be slowly injected into the targeted artery and the patient should be kept under close observation for blood reflux. Usually, the embolization of abnormal branches of external iliac artery will not cause ischemic symptoms of the pelvis and distal limbs.

Objective To evaluate the efficacy of dual stent placements for the treatment of occlusion/stenosis of subclavian artery associated with stenosis of adjacent vertebral artery initial site. Methods The clinical data of 9 patients with occlusion/stenosis of subclavian artery associated with stenosis of adjacent vertebral artery initial site were retrospectively analyzed. Stent implantations in the affected subclavian artery and vertebral artery were separately performed; the patients were followed up for 3-12 months after the treatment. The therapeutic efficacy was evaluated with the clinical symptoms and Doppler ultrasonic examination. Results Successful implantation of two stents was accomplished in all 9 patients, with the technical success rate of 100%. After the treatment, the blood flow in both the subclavian and vertebral arteries was unobstructed. Following-up examination showed that the subjective symptoms were obviously improved in all 9 patients, and no serious procedure-related complications occurred. Doppler ultrasound examination showed that no in-stent restenosis or stent displacement was observed. Conclusion For the treatment of occlusion/stenosis of subclavian artery associated with stenosis of adjacent vertebral artery initial site, dual stent placement technique is a safe and feasible means with satisfactory effect in improving vertebro-basilar arterial insufficiency.

Objective To evaluate and compare yeast identification ability between Bruker Microflex matrix-assisted laser desorption ionization-time of flight mass spectrometry( MALDI-TOF MS) and Vitek 2 Compact automatic microbial analysis system.Methods Retrospective study.Totally 742 strains of yeast isolated from clinical specimens during March 2013 to March 2014 in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine were identified by Bruker Microflex MALDI-TOF MS and Vitek 2 Compact automatic microbial analysis system simultaneously.The strains with discordant results were validated by gene sequencing.Results The coincidence rate of 699 Candida identified by Bruker Microflex MALDI-TOF MS or Vitek 2 Compact system was 100.0%(699/699) and 99.6%(696/699) to the species level, respectively and the coincidence rate of 43 yeast-like fungi strains identified was 90.7%(39/43) and 79.1%(34/43) to the species level, respectively.Penicillium marneffei could not be identified by both two instruments, but protein profile of Penicillium marneffei by MALDI-TOF MS was established.Conclusions The coincidence rate of yeast identified by Bruker Microflex MALDI-TOF MS is higher than that of Vitek 2 Compact system.Using Bruker Microflex MALDI-TOF MS to identify yeast especially Candida and yeast-like fungus is fast, simple, low-cost, accurate, and it can be used in routine work of ordinary yeast identification in clinical microbiology laboratory.