ObjectiveTo investigate the clinical value and pathological basis of peritumoral hyperenhanced rim (PHR) of renal cell carcinomas (RCCs) on CEUS.MethodsCEUS images of 53 patients with 54 renal tumors (27 RCCs,27 renal angiomyolipomas) were analyzed,and the detection and distribution of PHR were evaluated.HE staining and immunohistochemistry of CD34 were performed in tissue surrounding RCCs (TSR) to observe distribution of psuedocapsule,large vessels,and microvasculars among TSR with different modes of PHR.ResultsPHR was found only in RCCs.PHR distribution between RCCs and angiomyolipomas was statistically different (P＜0.05).Using PHR to diagnose RCC,the sensitivity,specificity,positive predictive value,negative predictive value,false positive and false negative was 44.44％ (12/27),100％ (27/27),100％ (12/12),64.29％ (27/42),0 (0/27) and 35.71％ (15/42),respectively.Pseudocapsule distribution between RCCs with PHR and RCCs without PHR was not statistically different (P＞ 0.05).There were rich large blood vessels in TSR with PHR in washin and both phases,and few or thimbleful large vessels were found in TSR without PHR in washout phase.Cancer tissue near the boundary (CTNB) of TSR had the highest microvessel density (MVD).MVD differences in different TSR with PHR were statistically different between washin and washout phases,washin and both phases,both phases with PHR and without PHR (P＜0.05),but no statistical difference was found between washout and both phases (P＞0.05).ConclusionPHR is a highly specific complementary indicator in diagnosing RCC,and it is correlated with rich blood vessels in TSR and (or) a higher MVD value in CTNB.

The gene silence induced by small interfering RNA (siR N A) provides a powerful tool for gene therapy of neoplasm. However, safe and efficient delivery of exogenous siRNA is still the key issue for clinical application. Polyethyenimines ( PEI ) and its copolymers can encapsulate siRNA into complex in the formation of nanoparticle wherein the stability and activity of siRNA are closely related to the structure and molecular weight of PEI, N/P ratio, and the composition of copolymers.The siRNA-encapsulated nanoparticles can effectively inhibit the proliferation of tumor cell not only in vitro, but also in vivo by administration via intratumoral,intraperitoneal or venous injections.

Objective　To investigate the changes in the e xpressions of P53 mRNA and Bcl-2 mRNA in spermatogenic cells in rats after expo sure to ultrasound to elucidate the possible mechanisms underlying the apoptosis induced by ultrasound at genetic trascription level. Methods　Thirty-two healthy male SD rats,（30±2） days old and (70±5) grams body weight, were randomized into 4 groups (n=8) according to the time of exposure to ultrasound,including control group without exposure,gr oups of 10 minutes, 20 minutes and 30 minutes with exposure to ultrasound for 10 ,20 and 30 min,respectively. Samples were taken 24 hours after exposure to ultra sound,then 4% paraformal-dehyde fixed,paraffin-embedded and sectioned into 4 μm sections (slides were pretreated with APES and poly-lysine). P53 and Bcl-2 in situ hybridization kits were purchased from Wuhan Boshida Bio-engineering C o.Results　There was no significant difference in the expressions o f P53 mRNA or Bcl-2 mRNA in sperematogenic cells in rats between the control gr oup and 10 minutes group. The expressions of P53 mRNA in groups over 10 minutes were up-regulated and that of Bcl-2 mRNA were down-regulated. P53 mRNA in s permatogenic cells in rats was increased from (44.13±5.05)% in control group to (60.47±6.57)% in group 30 minutes. Bcl-2 mRNA was decreased f rom (40.29±9.10)% in control group to (31.01±5.67)% in group 3 0 minutes. Conclusions　Exposure to ultrasound over 10 minutes can induce up -regulatory expressions of P53 mRNA and down-regulatory expressions of Bcl-2 mRNA in spermatogenic cells in rats.

0.05). Conclusions As for diagnosis of Sjogren syndrome,ultrasonography examination is the first choice,and for atypical ones,lip gland biopsiy follows.

Objective To investigate the features of renal lesions in von Hippel-Lindau (VHL) disease and the surgical intervention. Methods The clinical and pathological data from 6 patients with renal lesions in a large Chinese VHL disease kindred were reviewed individually.One patient had multifocal renal cysts,and 5 patients had bilateral renal cell carcinomas and multifocal renal cysts. Results Among 10 kidneys in the 5 cases of bilateral renal cell carcinomas, nephron-sparing surgery (NSS) was performed in 5,radical nephrectomy (RN) in 3 and observation in 2.After operation,the pathological findings indicated that all solid lesions were renal clear cell carcinoma, with one malignant cyst being detected.The Fuhrman's nuclear grade of the RCC was grade Ⅰ in 14 tumors,grade Ⅱ in 6 tumors.The TNM stage was T 1N 0M 0 in 4 cases and T 2N 0M 0 in 1 case.During a mean follow-up of 47 months (range,9 to 113 months),all patients were alive without evidence of RCC recurrence and metastasis.Five patients had normal renal function and 1 patient experienced an increase in serum creatinine but without dialysis. Conclusions The renal lesions in VHL disease include both cysts and carcinomas,which are often multifocal and bilateral.Almost all the tumors are of clear cell type with a low stage and grade.Nephron-sparing surgery may be justified and effective in the management of VHL patients.

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.

ObjectiveTo explore the correlation of contrast-enhanced ultrasound (CEUS) parameters and the pathologic parameter of renal fibrosis.MethodsThirty-eight healthy New Zealand rabbits were randomly divided into the blank control group and the experimental group. The rabbits model was built by intravenous injection of C-bovine serum albumin (C-BSA) to rabbits of the experimental group. According to the different time points (2, 4, 6 and 8 weeks) after the injection of C-BSA, the rabbits in experimental group were randomly divided into 4 sub groups, 8 in each group. We collected the data of the CEUS parameters in the control group and the experimental group. Moreover, the renal tissues of the rabbits underwent pathologic examinations. Then, correlation analysis of CEUS parameters with parameters of renal fibrosis was performed.ResultsDynamic changes of CEUS parameters: Renal cortical perfusion reduced from 6 weeks after the injection, manifested as the time to peak (TTP) and mean transit time (MTT) of the experimental group were longer than those of control group and the derived peak intensity (DPI) of the experimental group was lower than that of control group (P<0.05 respectively). The DPI and TTP at 8 weeks after the injection of the experimental group was significantly lower than those of the control group [(26.96±2.34) dbvs (35.04±1.62) db,P<0.05; (24.31±1.82) svs (18.64±1.15) s,P<0.01]. Changes of each renal fibrosis parameter: we found that the results of the glomerulosclerosis indexes of the experimental group (4 weeks, 6 weeks and 8 weeks after the injection) were significantly higher than those of the control group (0.81±0.36, 1.43±0.25 and 2.15±0.30vs 0.13±0.07, allP<0.01). The tubular interstitial collagen deposition scores of the experimental group (4 weeks, 6 weeks and 8 weeks after the injection) were significantly higher than those of the control group (14.29%±4.62%, 26.28%±10.09% and 42.37%±10.41%vs 1.21%±0.15%, allP<0.01). As the disease progressed, the results of each parameter increased. Pearson correlation analysis showed that the TTP of renal cortex was positively correlated with the glomerulosclerosis index and tubular interstitial collagen deposition score (r=0.866 and 0.785, bothP<0.01). The DPI of renal cortex was negatively correlated with the glomerulosclerosis index and tubular interstitial collagen deposition score (r=-0.724 and -0.739, bothP<0.01).ConclusionsThe results showed that CEUS could evaluate microcirculation perfusion of renal cortex. There is a positive association between TTP and fibrosis index. There is a negative association between DPI and fibrosis index. Thus, CEUS is an important method to evaluate the renal fibrosis in chronic renal nephropathy.

Objective To compare blood flow perfusion conditions of renal allograft of different renal function with conventional ultrasound and contrast enhanced ultrasonography (CEUS). Methods Sixty patients underwent kidney transplatation were divided into normal group (SCr≤110 μmol/L) and abnormal group (SCr＞110 μmol/L). Renal structure and inner diameter of renal artery were messured with two-dimensional ultrasound. The hemodynamic parameters (PSV, EDV and RI) were messured with CDFI. Data of renal blood flow perfusion (AT, TTP, △I and Increase), data of renal blood flow perfusion (AT, TTP, △I and Increase) were quantitatively analyzed with CEUS combined with time intensity curve. All the data were compared between two groups.Results There was no significantly difference of above indexes for B-mode ultrasound and CDFI between two groups, except EDV of arcuate arteries. CEUS parameters of patients with normal renal function were better than those with abnormal function.Conclusion Microcirculation perfusion changes of transplanted kidney with abnormal function could be detected with CEUS. The quantitative indexes of transplanted kidney with normal function were better than those with abnormal function.