Objective To improve the cognition of abnormal changes of the medial soft tissue of styloid process (MSTSP) in nasopharyngeal carcinoma after radiotherapy. Methods CT scans of nasopharynx in 39 cases with NPC that had change at the MSTSP in NPC after radiotherapy were performed.CT findings of recurrence and non-recurrence at MSTSP were studied and compared carefully.Results In the recurrence cases, the MSTSP was thickening and compactness in all cases, in the non-recurrence cases ,only 37.04% (10/27) were thickening and compactness at MSTSP. In all the cases which had thickening and compactness of the MSTSP, the borders were slightly protruding in 9 cases and the borders were straight in 3 cases in the recurrence cases, while the borders were straight in 7 cases and the borders were slightly hollow in 3 cases,and there wasn't any case appeared as protruding of borders in the non-recurrence cases. All the cases were dealt with statistic methods and had remarkable difference between them(P

ObjectiveTo investigate the value of perfusion CT imaging in thyroid nodule. Methods Of the 40 cases of post-surgical thyroid nodule identified by pathology, nodular goiter was verified in 22 cases, thyroid adenoma in 6 cases,and thyroid carcinoma in 12 cases. All cases underwent CT perfusion scan at preoperative. The perfusion parameters including the blood flow ( BF), blood volume ( BV ), mean transit time ( MTT), and permeability of surface (PS) of region of interest (ROI) were calculated. The Mann-whitney test was used to comparing the differences of the different perfusion parameters. The ones with statistical significance would be introduced into the discriminatory analysis to distinguish the benign and malignant thyroid nodule. ResultsThe median MTT in 28 cases with benign thyroid nodule were 4. 33 s (Min 1.42 s,Max 10. 93 s), and that in 12 cases with malignant nodules were 2. 18 s( Min 1. 95 s, Max 2. 87 s). The difference had statistical significance ( P ＝ 0. 00 ) . The median BF in cases with thyroid carcinoma was 560. 23( Min 330. 66, Max 1000.00) ml ·100 g-1 ·min-1, and that in cases with the benign nodular were 374.79(Min 117.47,Max 1000.00) ml · 100 g-1 · min-1. There was a significant statistical difference ( P ＝0. 01 ). Through the discriminatory analysis, the difference of MTT between benign and malignant nodules were statistically significant (P ＝ 0. 00 ).After establing the Bayes discriminatory function, the overall diagnostic accuracy was 87.5％ (35/40).Conclusions MTT and BF are useful parameters in CT perfusion imaging to distinguish the benign and malignant thyroid nodules and the MTT is more accuracy.

Objective To detect apoptosis of transplanted lung adenocarcinoma cells in nude mice after 125I brachytherapy by 99Tcm-Annexin V combined with diffusion weighted MRI (MR-DWI).Methods Twenty-five BALB/c-nu nude mice models subcutaneously transplanted with A549 cells were divided into experimental group (EG,n=13) and control group (CG,n=12) by random number table method.One 125I seed with apparent activity of (24.8±6.3) MBq was implanted into each mouse in EG,while CG underwent cold seed implantation.Both of 99Tcm-Annexin V imaging and MR-DWI were performed within 7-10 d after brachytherapy,then all mice were sacrificed and tumor cell apoptosis was detected by terminal oxynucleotidyl transferase mediated dUTP biotin nick end labeling (TUNEL) immunofluorescence,Survivin expression was assayed by SP.Two-sample t test,x2 test and Pearson correlation analysis were used for data analysis.Results Positive rate of cell apoptosis by 99Tcm-Annexin V imaging was 69.2％(9/13) and 8.3％(1/12) respectively in EG and CG (x2 =12.73,P＜0.01).The uptake ratio of 99Tcm-Annexin V,apparent diffusion coefficient(ADC) value and apoptosis index(M) of the tumor in EG were 2.91±0.85,(2.03±0.44)×10-3 mm2/s and (49± 18) ％,respectively,which were significantly higher than those of CG (1.26 ± 0.37,(1.29 ± 0.21) ×10-3 mm2/s and (11±4)％ respectively,t=5.930,5.452,7.606,all P＜0.05).Survivin expression in EG and CG was (46± 13) ％ and (15±7) ％ respectively (t =5.158,P＜0.05).The value of ADC was correlated with AI and uptake ratio(r=0.756,0.788,both P＜0.05).Uptake ratio was correlated with AI (r=0.754,P＜0.05),while Survivin expression was negatively correlated with AI (r =-0.772,P＜0.05).Conclusions Down-regulation of Survivin expression may play an important role in apoptosis induced by 125I brachytherapy.99Tcm-Annexin V combined with MR-DWI could effectively evaluate apoptosis of lung adenocarcinoma cells in a non-invasive way,thus it might be helpful in evaluation of early efficacy of 125I brachytherapy.

OBJECTIVE To study the clinical usability of virtual endoscopy(VE) in tympanoplasty.METHODS A total of 102 patients (204 ears) were observed by virtual endoscopy. Tympanoplasty was performed in 72 cases (75 ears) including 53 cases (55 ears) with chronic otitis media and 19 cases (20 ears) with congenital microtia and middle ear dysmorphia. Ossicular chain reconstruction was conducteded in 65 ears at the same time. RESULTS The ossicular chain was showed eroded in 19 ears of 23 patients with cholesteatoma otitis media pre-operatively by VE, but was found eroded in all of 23 ears during operation. The ossicular chain was showed eroded in 29 ears of 32 patients with osteitis otitis media pre-operatively by VE, but during operation it was found 23 ears with malleus and incus eroded, 11 ears without head of stapes or up-structure of stapes. VE showed 18 ears with congenital microtia and middle ear malformation and 2 ears with small tympanic cavity and no ossicular chain preoperatively, and operation proved 17 ears with severe ossicular malformation, 2 ears without stapes, 1 ear with vestibular window atresia. There were 2 ears with sudden hearing loss after tympanoplasty, the VE showed ossicular displacement. The coincidence rates between VE and operation view were 92 % in patients with otitis media and 100 % in patients with congenital microtia and middle ear malformation. CONCLUSION VE can supply reliability data for evaluation of the damaged ossicular chain and efficacy of tympanoplasty.

OBJECTIVETo observe treatment response, survival, safety and the improvement of ECOG in patients with refractory multiple myeloma (MM) with serious heart failure after the administration of continuous low-dose of cyclophosphamide combined with prednisone (CP).

METHODSFrom January 2005 to September 2013, a total of 75 patients were treated by metronomic chemotherapy with continuous low-dose cyclophosphamide (50 mg/d) and prednisone (15 mg/d).

RESULTSAmong the 75 patients, 2 were lost for follow-up. In the 73 available patients, the overall response was 64.4%, including 2 patients (2.7%) with complete remission (CR), 4 cases (5.5%) very good partial remission (VGPR), and 24 patients (32.9%) partial remission (PR). The median survival was 12 months (1-70 months) with a median onset time of 90 days (16-120) and a median progressive freedom survival of 12 months (1-60). The level of B-type natriuretic peptide in responders declined significantly, as compared to no responders [(336.6 ± 30.3) ng/L vs (906.4 ± 104.8) ng/L, P<0.01]. Common adverse events were as follows: 32 (43.8%) cases of bone marrow suppression, 26 (35.6%) cases of infection, 8 cases of dizzy as well as sleepiness (11.0%), 7(9.6%) cases of Cushing syndrome, 4 (5.5%) cases of secondary diabetes mellitus, and 3 (4.1%) cases of edema respectively.

CONCLUSIONThe metronomic chemotherapy of cyclophosphamide combined with prednisone had satisfactory impact on the treatment outcome, including the improvement of cardiac functions and physical capacities, better survival and safety in refractory MM with serious heart failure. It provides a novel regimen for such patients.

Cholangitis, Sclerosing ; etiology ; Genetic Predisposition to Disease ; Hepatitis, Autoimmune ; etiology ; Humans ; Liver Cirrhosis, Biliary ; etiology

ObjectiveTo investigate the imaging characteristic of DW1,tumor cell apoptosis and proliferation of nasopharyngeal carcinoma (NPC) xenograft transfected hNIS gene after 131Ⅰ treatment.MethodsThe NPC xenograft models were established with CNE-2-hNIS cells(experimental group) and CNE-2 cells(control group) respectively.After i.p.injections 131Ⅰ in the experimental group and control group,the changes of xenograft tumor volume and ADC value were observed in 3,6,12,18,24 days by MR scan.The correlations of changes of ADC with pathological TUNEL,Caspase-3 immunohistochemistry of apoptosis,and Ki-67 proliferation detection were further investigated.Independent samples t-test were compared between the two groups and Pearson linear correlation analysis was used.ResultsThe tumor volume of the experimental group was significantly reduced compared with that of the control group after 131 Ⅰ treatment (t values:8.27-19.46,P ＜0.05 ).DW-MRI showed that in the 3th day after 131Ⅰ treatment,ADC values increased in the experimental group,and ADC values reached the peak in the 6th and 12th day after 131Ⅰ treatment,then ADC values were decreased. ADC values after treatment was positively correlated with apoptotic index ( r =0.72,P ＜ 0.05 ) and caspase-3 positive rate ( r =0.65,P ＜ 0.05) and there was a negative correlation with Ki-67 proliferation index ( r =- 0.71,P ＜ 0.05 ).ConclusionADC values can reflect growth inhibition of NPC xenograft transfected hNIS gene after 131 I treatment.It is possible that DWMRI techniques can be used in early non-invasively monitor the therapy effect of 131Ⅰ treatment of NPC xenografts transfected hNIS gene.

Objective To observe the regulation of Fengxiaofang on the expression of gene Gob-5 in ovalbumin-challenged asthmatic mice. Methods The murine model of allergic asthma established by ovaibumin was used. The model mice were treated experimentally with Fengxiaofang and Dexamethasone as a positive control. The quantitive expression of gene Gob-5 in lung of mice was detected by real-time quantitative PCR. Results The expression of gene Gob-5 in lung of mice was down-regulated by Fengxiaofang. In the experiment, there were no significant differences between the one-fold or ten-fold dosage groups and the normal control group. Gene Gob-5 expression in five-fold dosage was significantly lower than that in the normal control group. Conclusion Fengxiaofang has the effect of lowering the expression of gene Gob-5 which maybe related to the potency on asthmatic disease.

Objective: To observe the promoting blood circulation by removing blood stasis of Lubai Capsule(LBC)(Rhizoma Phragmitis, Radix Paeoniae Alba, Radix Saposhnikoviae, Flos Schizonepetae, etc.). Methods: Acute blood stasis rat models were established with swimming in iced water and sc adrenalin in order to observe the effect of LBC on blood rheology. Mesenteric microcirculatory disturbance rat models were also established with adrenalin in order to observe the effect of LBC. Clotting time was measured in vitro with prothrombin time(PT) and kaolin partial thromboplastin time(KPTT) kit in order to observe its effects. Results: LBC could decrease the whole blood and plasma viscosity, fibrinogen, erythrocyte sedimentation and aggregation ratio of blood platelets of rats, ease the sticky condition of blood stasis rat models and prevent from forming thrombus. It could also inhibit the constraction and slowing of blood flow of thin artery, the reducing of open capillaries and change of fluid condition caused by adrenalin and improve these phenomena. PT and KPTT could be increased obviously. Conclusion: LBC can significantly promote blood circulation by removing blood stasis, because of improving blood rheology and mesenteric microcirculatory disturbance and inhibit endogenous and exogenous coagulation system.

Objective To study curative effect of edaravone on acute severe brain injury through the observation of neuron-specific enolase( that is:NSE) changes.Methods 60 severe brain injury patients were randomly assigned into the treatment group (n=30 ) and the control group (n=30).Besides the routine treatment,edaravone was used in the treatment group for 7 days.The control group received the same treatment except edaravone.NSE were measured in the two groups before the treatment and at 1st,3rd,5th,7th day after the treatment.GCS was evaluated at 21 days.Results Compared the NSE before treatment and after three days,they had significant difference(P＜0.05,also between the two groups and the GCS after 21 days.they had no significant adverse drug reactions during the two groups of patients with medication.Conclusion Edaravone for patients with severe brain injury has a better treatment effect,medication safety,fewer adverse reactions from the mechanism of NSE at acute phase.