With the wide application of Chinese herbal medicine around the world and the continuous perfection of adverse drug reaction monitoring system,herb-induced liver injury (HILI) has attracted more and more attention,but its actual incidence remains unknown.As is reported in the literature,its constituent ratio ranged from 20％ to 30％ and there are many clinical types,among which hepatocellular injury is the most common type.There are many causes of HILI,including pharmaceutical factors,factors associated with the human body,lack of preclinical evaluation,and unreasonable clinical application.Currently it is difficult to make a diagnosis of HILI,and tracing the source of Chinese herbal medicine may play an important role in the diagnosis of this disease.Liver injury induced by Chinese herbal medicine should be taken seriously and active diagnosis and effective prevention and treatment should be performed.

In light of the IT development in hospitals, the authors point out the necessity of setting up the post of CIO and clarify the role of the CIO in the construction and management of the hospital information system. They argue that the CIO should not only be in charge of the technology support of the information network platform, but also exercise the function of managing hospital information. While hospitals ought to attach importance to the development and application of information systems and the role of the CIO, the CIO, on his part, ought to try to enhance his competence and become a versatile talent expert at various disciplines like medicine, management and the computer.

Objective To observe the imaging features of primary hepatic endocrine carcinoma. Methods Three patients with primary hepatic endocrine carcinoma proven pathologically were retrospectively analyzed. Results Single liver lesion was detected in all 3 patients, 2 in right and 1 in left lobe of liver. The maximum diameter of the masses was 4.8 cm, 6.7 cm and 10.0 cm, respectively. The masses were all solid with different extent of low density. The solid part enhanced greatly in contrast enhanced CT scanning, while the non-solid part did not. The bigger lesions pushed the vascular to move aside in 2 patients. Enhanced and circuitous vascular was observed in 1 lesion. Slightly low signal was noticed on MR T1WI , while high signal was found on T2WI and DWI. Conclusion CT and MR can show specific features of primary hepatic endocrine carcinoma, i.e. usually single solid mass with various low densities inside and the solid part enhancing dramatically.

Objective To investigate the short-term effects of intra-articular injection of hyaluronan on proprioception of the knee in gerontal patients with osteoarthritis (OA). Methods The 53 gerontal patients were included in this study. The study included treatment group (n=35) and the placebo group (n=18). Hyaluronan was intra-articularly injected into both knees of the subjects in treatment group, whereas physiological saline was intra-articularly injected in the placebo group. Proprioception test was performed, and Western Ontario and McMaster Universities(WOMAC) scales were used to evaluate pain and physical function. Results Statistical analysis was performed on 100 knees of 50 patients who completed the trial. Compared with the placebo group,the average absolute angular error (AAAE) value in the treatment group was detected to be statistically lower one week after the 4th injection (1.8±0.9 vs.2.9±1.1,t=2.42,P=0.02),and WOMAC was lower in the treatment group after one week (8.7±3.1 vs.11.5±4.0, t=0.73,P＜0.05). Conclusions Intra-articular injection of hyaluronan in gerontal patients with knee OA leads to a short-term increase in proprioception, and significant improvement in the functional conditions of patients.

Objective To study the perfusion imaging features of renal cell cancer(RCC) and their correlation with microvessel density(MVD) and vascular endothelial growth factor(VEGF) ex-pression status. Methods Dynamic contrast-enhanced multislice spiral CT was performed preopera-tively in 73 cases with histologically proven RCC (65 cases of clear cell carcinoma, 3 of papillary ade-nocarcinoma, and 5 of chromophobic carcinoma). Blood volume (BV), blood flow (BF), mean transit time (MTT), and permeability surface area product (PS) of tumors were recorded. MVD and VEGF expression status were studied by immunohistochemial staining. Results The mean BV, BF, MTT negative in 35 (47.9 %) cases, slightly positive in 24 (32.9 %) cases, moderate positive in 10 (13.7 %) cases, and intensively positive in 4 (5.5 %) cases. MVD of RCC was positively correlated with BV, BF and PS (P<0.01),and negatively correlated with MTT (P<0.05). No relationship was found be-tween the expression of VEGF and perfusion CT parameters. Conclusion Perfusion CT scan is use-ful to evaluate the angiogenesis status of RCC.

Pre-S2 protein in 78 samples of liver from patients with various types of hepatitis B was determined by immunohistochemical method.45 out of 78 samples (57.69%) were positive for pre-S2.The location and expression patterns of pre-S2 were similar to those of HBsAg,i.e.,pre-S2 was found in cytoplasm of hepatocytes,epithelial cells of bile ducts,and hepatocellular carcinoma cells,etc,Four different patterns diffuse,inclusion,submembranous,and membranous type were demonstrated.The membranous expression of pre-S2 was often associated with activity of liver diseases.The positive rate of pre-S2 was significantly higher in HBcAg positive group than HBcAg negative group.It seems that pre-S2 protein of HBV may be a replicative marker of HBV.

Objective To compare the value of diffusion kurtosis imaging (DKI) mode and mono-exponential mode in predicting the response to neoadjuvant chemotherapy (NAC) for locally advanced breast carcinoma using DWI.Methods From January 1,2013 to December 31,2016,eighty patients with locally advanced breast carcinoma were enrolled into this prospective clinical study.The diagnosis was confirmed on the basis of histopathological results.The clinical stage stayed at Ⅱ or Ⅲ.The patients would receive breast-conserving surgery after NAC.All the patients underwent DWI examination by using both mono-exponential mode and DKI mode before chemotherapy was initiated.The parameters included ADC,mean diffusivity (MD) and mean kurtosis (MK).Within 1 to 3 days before or after MRI examination,the patients underwent aspiration biopsy,received 4 to 8 cycles of NAC and followed by surgery.According to histologic grading before NAC,the patients were classified into well-differentiated and poor-differentiated group.According to the comparison between pathological results acquired from biopsy before NAC and specimen acquired after surgery,the patients were classified into pathologic complete response (pCR) and pathologic non-complete response (non-pCR) according to treatment effect.The imaging parameters were compared between the pCR and the non-pCR group using t test.The predicting ability of two imaging modes was compared and analyzed with ROC analysis.The relationships between multiple imaging parameters,pathologic,clinical characteristics of tumor and treatment effect were analyzed using logistic multi-variate regression analysis,and further analyzed using Wald test.Results There were 30 cases of pCR and 50 cases of non-pCR.The ADC and MD values were lower in the pCR group than in the non-pCR group (P＜0.05).MK value was higher in the pCR group than in the non-pCR group (P＜0.05).ROC analysis showed that the area under ROC curve of ADC,MD and MK in predicting treatment effect were 0.732,0.866 and 0.683 respectively.Logistic regression analysis showed that,according to predicting ability,MD,ADC and MK successively were the independent predictors for the early response to chemotherapy.Conclusion Compared with mono-exponential mode,DKI mode can reflect the real micro-environment and water diffusion restriction within the tumor area more reliably and accurately,and is more suitable to serve as an imaging technique for predicting the response to NAC for locally advanced breast carcinoma.

OBJECTIVETo analyse the features of gray scale and colour Doppler sonography for carotid body tumor, to improve the sonographic diagnostic accuracy.

METHODSA retrospective review was performed of sonographic material of 18 carotid body tumors by gray scale sonography and 11 by colour Doppler sonography, with comparison with other diseases which are frequently misdiagnosed as carotid tumor.

RESULTSWell-defined, even weakly hypoechoic masses were noted on gray scale ultrasonogram at the carotid bifurcation, commonly broadening the carotid bifurcation and often encasing the common, external and internal carotid arteries. Disorderly non-echoic channel- like structures in the tumor were sometimes observed. Colour Doppler sonography showed abundant flow in the tumor. The non-echoic channel- like structures were vascularities. Seventeen masses diagnosed by ultrasound were proved to be carotid body tumors. The other was confirmed as a neurogenic tumor, giving an accuracy rate of 94.4% for sonographic diagnosis.

CONCLUSIONSonographic examination of the carotid body tumor is highly accurate. It is safe and reliable.

Adult ; Aged ; Carotid Body Tumor ; diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography, Doppler, Color

OBJECTIVETo evaluate the CT and MR findings of retroperitoneal ectopic pheochromocytoma.

METHODSTo analyze retrospectively the CT and MR images of 32 patients with retroperitoneal ectopic pheochromocytoma proved by pathology.

RESULTSThe lesions (benign=28, malignant=4) were located in the anterior pararenal space (ARS) (n=12), the perirenal space (PS) (n=13) and the posterior pararenal space (PRS) (n=7). The tumors showed heterogeneous density on unenhanced CT (n=25). Among the 23 cases with enhanced CT imaging, 19 cases had marked contrast and 4 had mild contrast. The enhancement patterns included whole enhancement (n=9), solid area enhancement (n=12), peripheral enhancement (n=1), and spotted enhancement (n=1). The tumors had heterogeneous signal on unenhanced MR (n=23), and usually showed enhancement at arterial, portal and delayed phases on 22 enhanced MR, while cystic area with no enhancement. The lesions usually had cystic changes (n=18), septa (n=16), vessels inside (n=9), hemorrhage (n=3), and calcification (n=3). Besides that the morphology had statistical significance (P=0.013), other indexes had no statistical significance (P>0.05) in differential diagnosis of benign and malignant retroperitoneal ectopic pheochromocytomas.

CONCLUSIONSRetroperitoneal ectopic pheochromocytomas have some CT and MR features, usually revealed as an oval mass, growing along the paravertebral axis, and often with cystic changes. Those signs combined with hypertension and elevated catecholamine level may lead to a correct diagnosis.

Adrenal Gland Neoplasms ; diagnostic imaging ; pathology ; Calcinosis ; Diagnosis, Differential ; Humans ; Hypertension ; Image Enhancement ; Pheochromocytoma ; diagnostic imaging ; pathology ; Retroperitoneal Space ; Retrospective Studies ; Tomography, X-Ray Computed