Objective To explorethe chest x-ray and MSCT findings and the diagnostic value of pulmonary lymphangioleiomyomatosis (PLAM).Methods Four cases of PLAM proven by pathology were retrospectively analyzed,and the literature was reviewed.Result The clinical manifestations were dyspnoea(4 cases),cough(2 cases),haemoptysis(2 cases),recurrent pneumothorax(2 cases)and chylous effusions (1 case).The chest radiography presented diffused reticular shadows(2 cases),honey-comb changes(1 case),pneumatothorax(2 cases),and pleural effusion(1 case).The characteristic MSCT manifestations of 4 cases with PLAM were multiple different-sized and thin-walled cystoid transparent areas, which were diffusely-distributed throughout both lungs,most cysts were of 3-15 Him in diameter.One case combined with extensive pulmonary interstitial fibrosis,pleural thickening and adhesion.Conclusions PLAM is a kind of exceptional chronic diffuse lung interstitial disease.The chest radiography has been lack of characteristic imagines,but MSCT has characteristics of PLAM,and is more valuable for accurate clinical diagnosis of PLAM.

Objective To evaluate the clinical application value of susceptibility weighted imaging (SWI) in neonatal hy-poxic ischemic encephalopathy (HIE). Methods Thirty-six neonates with HIE were collected and scanned by GE 3.0 T supercon-ducting MR scanner. Routine axial T1WI, T2WI, FLAIR scan and axial SWI scan were conducted. SWI sequence was compared with conventional head MRI sequences in detection rate of distribution and quantity of intracranial hemorrhage. Meanwhile, the display condition of the dilated cerebral deep veins and cortical veins was observed on SWI image and the performance of HIE in different clinical classification on SWI was compared. Results A total of 97 intracranial hemorrhages were detected by SWI in 27 cases. Only 41, 27 and 51 hemorrhages were found by TIWI, T2WI and FLAIR sequences, respectively. SWI were significantly superior to T1WI, T2WI and FLAIR in displaying the size, scope and boundary definition of hemorrhage. A total of 50 dilated ce-rebral deep veins and cortical veins were detected by SWI in 22 cases which were not found by conventional head sequences. The detection rates of intracranial hemorrhage and intracranial hemorrhage in addition of dilated cerebral veins on SWI sequence were the lowest in mild HIE group, and highest in severe group. There was significant difference among the mild, medium and severe groups (P<0.05). Conclusions SWI sequence has higher sensitivity than conventional MRI sequence in detecting intracranial hemorrhage and dilated vein in HIE, and is useful for early diagnosis of HIE.

Objective To discuss influence factors on prognosis of the patients with capillary leak syndrome (CLS) in ICU.Methods The clinical data of 191 patients with CLS in ICU were reviewed,and the patients were divided into three groups according to prognosis:death group ( n =37),cured group ( n =132) and non-healed group (n =22).The clinical data of death group were compared with those of cured group at admission,during the course of CLS and before discharging from hospital.Results Compared with the cured group,the central venous pressure and serum albumin decreased ( P ＜ 0.01 ) ; anion gap,triglycerides,pressure adjusted heart rate (PAHR) and oxygenation index were lower ( P ＜ 0.01 or P ＜ 0.05) ; serum glucose and SIRS score increased ( P ＜ 0.01 ) in death group.There was higher rate of poor renal function at admission in death group than that in other groups ( P ＜ 0.01 ).There were more many patients treated with intravenous administration of hydroxyethyl starch,ulinastatin and continuous blood filtration therapy in cured group than those in other groups ( P ＜ 0.05).Conclusions The factors influencing the outcomes of the patients with CLS were hypovolemia,severe hypoproteinemia,interior milieu disorder,malnutrition,hypoxemia,renal injury and severe systemic inflammatory response.The outcomes of patients with CLS in ICU could be improved by using hydroxyethyl starch,ulinastatin and continuous blood filtration therapy.

ObjectiveTo investigate the short- and long-term effects of radiofrequency ablation (RA) versus minimally invasive hepatectomy (MIH) in the treatment of small hepatocellular carcinoma (SHCC). MethodsPubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI, Wanfang Data, and VIP were searched for Chinese and English articles on RA versus MIH in the treatment of sHCC published up to August 2019. Quality assessment was performed for the articles included, and RevMan 5.1 was used for analysis. ResultsA total of 7 studies with 737 patients were included after screening, and there were 393 patients in RA group and 344 patients in MIH group. Compared with the MIH group, the RA group had significantly shorter time of operation (mean difference ［MD］=-206.57, 95% confidence interval ［CI］: -387.28 to -25.86, P=0.03) and length of hospital stay (MD=-4.02, 95%CI: -4.94 to -3.10, P＜001), as well as a significantly lower overall incidence rate of postoperative complications (odds ratio ［OR］=0.31, 95%CI: 0.20-047, P＜0.01). Compared with the RA group, the MIH group had significantly higher 3-year overall survival rate (OR=0.55, 95%CI: 0.36-0.84, P＜0.01), 1-year disease-free survival rate (OR=0.63, 95%CI: 0.41-0.98, P=0.04), and 3-year disease-free survival rate (OR=0.51, 95%CI: 0.34-0.74, P＜0.01), as well as a significantly lower local recurrence rate after surgery (OR=187, 95%CI: 1.31-2.68, P＜0.01). ConclusionIn the treatment of sHCC, RA has good short-term effect, good safety, and poor long-term effect, while MIH has good long-term effect and poor short-term effect.