BACKGROUND: Tumor spinal metastasis is often complicated with pain,limitations in movement, paralysis and poor prognosis.OBJECTIVE: To investigate the factors affecting the recovery of the spinal functions in patients with spinal metastatic carcinoma and its therapeutic methods so as to improve the living quality of the patients with a terminal cancer.DESIGN: A case-controlled observation.SETTING: The Department of Tumor and Department of Radiotherapy of the Affiliated Hospital of Guangdong Medical College.PARTICIPANTS: We selected 162 patients with spinal metastatic carcinoma with different degrees of paralysis who received treatment at the Department of Oncology and the Department of Radiotherapy of the Affiliated Hospital of Guangdong Medical College between March 1992 and June 2001. They participated in this experiment voluntarily.METHODS:①Radiotherapy and chemotherapy; All the patients were given symptomatic treatment with simple radiotherapy or a combined therapy of simple radiotherapy and chemotherapy, in which the dose of chemotherapy was 2 Gy/time,5 times a week,3 weeks in total. A combined method was used for chemotherapy according to the nature of the different primary tumors. The chemotherapy was conducted for 3 therapeutic courses in average ranging from 2 to 6 courses of treatment with 21 days for each course. ② Physical rehabilitation therapy included exercise therapy, massage (twice/day), functional electrical stimulation (once a day),bladder training and toilet training (once or twice every day), 10 days as a therapeutic course, 3 successive therapeutic courses in total. After the treatment, analgesic pain, muscle power of the limbs and the recovery of defecation function were observed.MAIN OUTCOME MEASURES: Pain-alleviating, muscle power of the limbs and the recovery of defecation function after the operation. RESULTS: Totally 162 patients with spinal metastasis carcinoma were recruited, and all the patients entered the stage of result analysis at the end of therapy with no loss in the midway. ① Pain complete alleviating was in 97 cases (59.88%); no alleveclting in 0 case. ② The condition was remarkably improved in 127 cases(78.40%), and it was not improved in 35 cases (21.60%). The improved rate of muscle power of the patients with one focus and 2 adjacent focuses was 92.98%. The improved rate of the patients with multiple foci was 64.59%. The muscle power of the patients with a disease history of less than 2 weeks was improved remarkably, but there was no change in muscle power in patients with a disease history of more than 2 months. CT or MRI showed that spinal cord at the affected segment of the 21 patients suffered severely compression before the treatment, and only 2 cases were improved in muscle power, with no other changes.③The defecation function of 162 patients all became normal.CONCLUSION: Patients with spinal metastatic carcinoma complicated with paralysis have different degrees of relief and amelioration in pain,muscle power of the limbs and defecation function after radiotherapy,chemotherapy and synthetic rehabilitation therapy. Factors affecting the recovery of spinal function mainly included the length of disease course,compressed degree of the spinal cord, the quantity of metastatic focus, the health status of the patients and therapeutic time and the quality of primary rehabilitation and so on. Mental help to the patients should be paid attention to so as to improve the quality of life at the same time.

Objective To study antioxidant activity of extract of Cassia obtusifolia. Method The free radical-scavenging effect of the extract was evaluated in the flavins system; erythrocyte membrane was exposed to three radicals generation systems, the inhibition of the extract on lipid peroxidation was determined. Results The extract showed strong scavenging effect on superoxide radical and dose- dependently inhibited the increases of lipid peroxidation content in the membrane exposed to xanthine-xanthine oxidase system, H2O2 or UV light. Conclusion Antioxidant activity of the extract was obvious.

The X-ray computed tomography (CT) appearance of 4 cases with pulmonary cryptococcosis (PC) diagnosed by pathological examination in our hospital was retrospectively analyzed. The appearances of PC on CT were various: solitary lesion in 1 case, multiple lesions in single lobe in 2, and multiple lesions in multiple lobes in 1. There were total 52 lesions in 4 cases; the diameter of nodules or masses was 3 - 75 mm. Cavitations were found in 1 case; lesions appeared obviously enhanced and one lesion showed central necrosis. Two cases underwent pulmonary lobectomy; and 2 cases received core cutting needle biopsies, after antifungal therapy for 3 months to 1 year the lesions showed being absorbed. In summary, the CT appearance of PC is non-specific with various modes and forms. PC should be considered when multiple nodules or masses scattered in subpleural zone, accompanied with ground-glass opacity and obviously enhanced. The examination of pathogen and pathology at the beginning is crucial for improving diagnostic accuracy.

Objective To evaluate the CT features of the uncommon neoplasms of the paranasal sinuses and nasal cavity and related differentiate diagnosis.Methods CT manifestation of 26 cases with uncommon neoplasm of the paranasal sinuses and nasal cavity confirmed by histopathology were retrospectively analyzed and compared with 9 cases of common malignant neoplasm. Results All cases had soft-tissue mass with sinusitis in most cases (27/35).In benign group, 7 cases appeared as common benign tumor except for the hemangioma with marked enhancement and meningioma with calcification . In the malignant group, melanoma was small in volume and malignant granuloma was in infiltrative growth .The others had common appearances of malignancies.Conclusion CT signs are not characteristic in most cases compared with the common neoplasms. Surface configuration, bony change and circumstances are the main considerations in differentiate diagnosis and should be related to clinical and pathological materials..

Objective To evaluate the clinical value of dual-energy CT in the detection of monosodium urate crystals in patients with gout.Methods One hundred and eight patients who experienced unilateral arthrocele and (or) joint pain in the past two weeks were enrolled into our study.DECT were performed for the upper or lower extremity.Ninety-five patients were enrolled into the gout study group based on the American rheumatism association (ACR) classification standard;The 0.3 linear blended images group were regarded as conventional CT group,DE (80 kV and 140 kV) datasets were reconstructed via gout-recognition software,the pseudo-color images group as the postprocessed group.Imagings were reviewed independently by two senior radiologists.Chi-square test were used for statistical analysis with the SPSS 13.0software.Results In the conventional CT group,DECT scans revealed a total of 298 areas of urate deposition in 51 patients;The sensitivity,specificity,and accuracy were 53.7％,84.6％,and 57.4％.In the postprocessed group,401 areas of green urate deposition were detected in 69 patients,the sensitivity,specificity,and accuracy were 72.6％,100.0％,75.9％ respectively,the differences had statistical significance (x2 =7.329 and 8.333,P ＜ 0.05).Conclusions DECT gout recognition technology can detect smaller amount of monosodium urate in the other parts of the body,with a great potential in early diagnosis and treatment monitoring of patients with gout.

Objective To explore the role of Color Doppler Flowing Imaging(CDFI) in assessing metastatic lymph node for nasopharyngeal carcinoma (NPC). Methods Neck lymph node were detected by CDFI in 206 patients who received the initial course radiotherapy in our hospital. The characteristic of neck node, such as position, figure, number, size, its relation to surrounding soft tissue, the ratio of longitudinal diameter over trnsverses′(L/T) and blood flow resistance index (RI), were recorded detailedly. Fine needle aspiration biopsy was performed on some of patients under the guide of ultrasound. Results The clinical N-stage was changed markedly after CDFI plus biopsy, with up-staging in 25 from N0 to N1 , 6 N0 to N2, 20 N1 to N2, 3 N1 to N3, 4 N2 to N3; and down-staging in 14 from N2 to N1, 7 from N3 to N2. The misdiagnosis rate of node involvement by palpation was 38.3% (79/206). The sizes of lymph node detected by palpation were larger than those by CDFI (P0.6, and the value would reached to 92.9%(182/196) and 95.5%(107/112)when such criteria combined with the diameter and growth behavior of lymph node. Conclusion Color Doppler Flowing Imaging is useful in N-staging for nasopharyngeal carcinoma by providing more reliable evidence.

ObjecfiveTo investigate clinical features and imaging manifestation in patients with posterior reversible eneephalopathy syndrome (PRES) to improve its recognition.MethodsSix patients with PRES were enrolled,four women with history of end-stage renal disease,kidney transplantation,eclampsia,or systemic lupus erythematosus (SLE) and two men with history of chemotherapy or hypertension.All of them underwent multi-serial MR imaging (T1 WI,T2 WI,FLAIR) and post-contrast T1 WI.Three cases also underwent CT scan and gadolinium enhancement. ResultsAll the six cases of PRES had different inducing causes such as acute hypertension,preeclampsia or eclampsia, taking immunosuppressive agents or steroids.and their clinical symptoms were characterized by sudden occurrence of headache,eclampsia or seizure of epilepsy,altered melltal status,visual disturbances.Clinical symptoms were died out in about one week after prompt and appropriate treatments for high blood pressure.or removal of precipitating factors,or treatment for epileptic seizures or status epilepticus.MRI and CT scanning demonstrated multifocal subcortical white lesions in bilateral parieto-occipital lobes (six cases), bilateralfrontal lobes (two cases),bilateral post temporal lobes (two cases) and left cerebellum (one cases).and cortical involvement (two cases).All lesions appeared unenhanced with gadolinium enhancement. FoHow-up by MRI showed decreased abnormal signs and small infarct foci were left in the cortex-subeortex of one case.ConclusionsPRES is a clinico-neuroradiologieal transient condition, usually benign and reversible in nature.Completely clinical and radiographic recovery Can be achieved with prompt antihypertensive treatment or removal of precipitating factors and supportive care,but delayed diagnosis and therapy Can result in cerebral infarct with neurological sequelae.

Objective To understand the status of depression and quality of life in the patients with advanced gastric cancer , and to explore their relationship .Methods The depression self rating scale (SDS) and the Chinese Scale of World Health Organiza‐tion Quality of Life Scale‐Brief Form Questionnaire (WHOQOL‐BREF) were adopted to conduct the questionnaire investigation on 131 patients with advanced gastric cancer ,then the results were compared with those of the health population .Results Among 131 patients with advanced gastric cancer ,the prevalence rate of depression was 47 .33% ,and the average SDS score was 45 .99 ± 15 .47 ,which were higher than those of the health population .The scores of quality of life were 61 .61 ± 12 .66 for the physiologic health domain ,59 .54 ± 12 .49 for the mental health domain ,64 .95 ± 14 .16 for the social relation domain and 52 .93 ± 14 .07 for the surrounding environment domain .There was a significant correlation between the depression score with the four domains scores of life quality ,in which the correlation with the mental health domain was strongest (r= -0 .636 ,r2 =0 .405) .Conclusion High depression level and poor quality of life exist in the patients with advanced gastric cancer ,and there is a correlation between them , in which the correlation between depression with the mental health domain is strongest .

Clinical data and manifestations on muhi-slice spiral CT (MSCT) of 11 patients with disseminated peritoneal adenomucinosis (DPAM) were retrospectively reviewed.The CT manifestations were also compared with surgical and histopathological findings.MSCT findings showed a large amount of gel-like ascites in 9 cases and local cystic masses in 2 cases.Among 9 cases with a large amount ascites,abdominal multiple cystic masses were shown in 5 case,and infiltration of the greater omentum and mesentery in 5 cases.Hepatic scalloping was found in 6 cases ; parenchymal invasion of the liver or spleen were showed in 5 cases; calcification of the cystic masses in 5 cases.Ovary mueinous cystadenoma was presented in 3 female patients.Enlarged lymph nodes and omental cake were not found in all cases.The results indicate that the characteristic MSCT manifestations of DPAM include diffuse gel-like ascites,multiple cystic masses with or without calcification,hepatic scalloping and parenchyma invasion.

Objective To establish a stable and efficient method of culturing imDCs in vitro,and to explore the effect of GW5074, which blocks ERK1/2 signal pathway in the process of imnature dentritic cells (imDCs) on inducing differentiation of the na(i)ve allogeneic CD4+ T cells into Treg cells in vitro. Methods The imDCs and mature DCs (mDCs) were isolated and cultured from the peripheral blood mononuclear cells (PBMC) derived from a healthy adult male volunteer, and they were identified by cell morphology, cell surface marker and cell functions respectively. Na(i)ve CD4+ T cells were isolated from newborn umbilical vein blood and were divided into 5 groups to be cultured: (1) Blank control group: Na(i)ve CD4+ T cells were cultured alone;(2) Positive control group: The irrDCs were Middle-concentration GW5074 group;(5) High-concentration GW5074 group. In the last three groups, imDCs and na(i)ve CD4+ T cells were co-cultured, the same as the positive control group, but these groups were added by GW5074 dilution at the concentrations of 8, 24, and 40μmol/Lrespectively. After co-culture for 5 days, the transformation ratio from naive CD4+T cells to Treg T cells was detected by flow cytometry. Results On the surface of imDCs, there was stronger pression of CD1a, but weaker expression of CD80 and CD83. On the contrary, on the surface of mDCs, there was weaker expression of CD1a, but stronger expression of CD80 and CD83. The stimulation index in imDCs group and mDCs group was 1.12±0.03 and 2.85±0. 07 respectively. The transformation ratio of Treg T cells in blank control group, positive control group, low-concentration GW5074 group, middle-concentration GW5074 group and high-concentration GW5074 group was (5. 81±1.36)%, (35.73±2.07)%, (22.53±2.11)%, (11.55±1.73)%, and (4.97±1.83)%respectively. One-way ANOVA analysis revealed that there was no significant difference between high-concentration GW5074 group and blank control group, P＞0. 05, but significant difference between the remaining groups, P＜0.01. Conclusion High purity of imDCs can be obtained from PBMC by induction with rhGM-CSF and rhIL-4. ERK1/2 signal pathway plays a role in inducing the immune tolerance. GW5074 can inhibit differentiation of na(i)ve CD4+ T cells into Treg T cells.