Five patients with pulmonary alveolar proteinosis admitted to Taihe hospital from 2006 to 2008, were treated by whole lung lavage under intravenous anesthesia, the clinical data were collected and analyzed retrospectively. The patients were followed up for 2 to 20 months, and their symptoms and pulmonary function were improved significantly after lung lavage treatment. Our experiences showed that lung lavage with intravenous anesthesia is the most effective treatment for pulmonary alveolar proteinosis.

Objective To investigate the features of PET-CT manifestation of pancreatic metastasis,and to improve its detection rate.Methods The PET-CT images of 31 cases of clinically diagnosed pancreatic metastases and 26 cases of primary pancreatic cancer were retrospectively evaluated.Two experienced specialists identified the lesion location in fused images.After frame by frame image analysis,the lesions with significantly increased radioactivity uptake were seen as positive,when compared with surrounding normal pancreatic tissue.The outline of regions of interest was drawn along the edge of the lesion shown in PET,and based on a semi-quantitative evaluation,the maximum standard uptake value (SUVmax) was calculated.If SUVmax ＞ 2.5,it was considered as positive.Results Among the 31 cases with pancreatic metastasis,22 cases of lung cancer,2 cases of gastric cancer 2 cases of colon carcinoma,1 case of maxillary sinus carcinoma,thyroid carcinoma,melanoma,renal cell carcinoma or gallbladder carcinoma were identified.Twenty-one cases (67.7％) were single,10 cases (32.3％) were multiple or diffuse lesions.Among the single lesions,7 (33.3％) were located in the pancreatic head and neck,14 in pancreatic body and tail.Among the 26 cases of primary pancreatic carcinoma,18 cases (69.2％) were located in the pancreatic head,8(30.8％) in the pancreatic body and tail.The sites of primary and metastatic pancreatic cancer were significantly different (x2 =6.012,P =0.014).CT scan showed only 17 nodular lesions with relatively low density and less clear boundary.PET images showed lesions in 31 cases of metastatic pancreatic cancer,and the mean SUVmax was 7.42 ± 3.48,which was significantly higher than that in primary pancreatic cancer group (5.39 ± 1.71,F =4.87,P =0.032).In addition,PET-CT identified 30 cases of other organs or lymph node metastasis.Conclusions PET-CT plays an important role in the diagnosis of metastatic pancreatic cancer.

Objective To investigate the role of spinal cord chemokine CXC ligand13(CXCL13) in the formation of rat bone cancer pain(BCP).Methods Twenty healthy female SD rats weighing 160-200 g were divided into four groups(n=5):sham operation group(S),BCP group(BP),small interference RNA(siRNA) negative control(NC-siRNA) group (NC) and CXCL13-siRNA group(CS).Normal saline was given by tibial medullary cavity injection in the S group.The tibial BCP model was established by tibial medullary cavity injection of equivalent Walker-256 breast cancer cells in the group BP,NC and CS.NC-siRNA lentivirus and CXCL13-siRNA lentivirus were injected intrathecally in the group NC and CS respectively.The mechanical pain threshold was measured on 1 d before model construction and on postoperative 7,9,14,21 d.The rats were killed after pain threshold measurement.The spinal cord and tibial tissue were taken.The co-expression of spinal CXCL13,microglia specific marker Iba-1 and neuron specific neucleoprotein NeuN was determined by using the immunofluorescence double standard staining,and expressions of CXCL13 and ionized calcium binding adaptor molecule-1 (Iba-1) protein and mRNA in spinal cord were detected by Western blot and RT-PCR;the HE staining microscopy was adopted to observe the tibial bone structure destroy situation.Results Compared with group S,the mechanical pain threshold in theBP group and NC group was decreased on 7-21 d after inoculation,CXCL13 expression in neuron was significantly increased and microglia was obviously activated,the expression of CXCL13 and Iba-1 protein and mRNA was significantly elevated (P＜0.05);compared with the NC group,the mechanical pain threshold on 9-21 d after model construction in the CS group was significantly increased,CXCL13 expression in neurons was significantly decreased,microglia activation was decreased and expression of CXCL13 and Iba-1 protein and mRNA was significantly decreased(P＜0.05);HE staining showed that the model groups appeared the tumor growth in bone marrow cavity,moreover which was eroded outwards and destroyed bone cortex,but no abnormality was found in the S group.Conclusion Spinal cord CXCL13 is involved in the BCP formation in rats by activating microglia.