Treatment and the clinical outcome of patients with head and neck cancer are determined by accurate staging and assessment of the cervical lymph nodes for metastases is an important step of this process. Ultrasonography, ultrasonography-guided fine needle aspiration (FNA), CT, MRI and PET/CT are used in the assessment of cervical lymph nodes. Ultrasonography guided FNA is advantageous in ease of application, minimumal invasiveness to patients, and less contraindications. Combined with cell block and molecular biology, FNA can be an effective tool for the diagnosis. The present article reviewed the diagnostic value of ultrasonography guided FNA in cervical lymph node assessment in patients with head and neck cancer.

Objective To evaluate the ultrasonographic ( US ) findings of granulomatous lobular mastitis( GLM ) ,and to compare the diagnostic accuracy among US ,mammographic ,and magnetic resonance imaging ( MRI) . Methods Imaging characteristics of 56 patients who were pathologically comfirmed as GLM were reviewed .All the lesions were assessed by BI‐RADS ( Breast Imaging Reporting and Data System) . Results Fifty‐eight lesions were found in 56 patients . Thirty ( 51 .7% ) were irregular ,20 (34 .5% ) were lobular and 8(13 .8% ) were round or oval in shape . Forty two lesions (72 .4% ) were hypoechoic ,14 (24 .1% ) were mixed echoic textur ,including 6 lesions (10 .3% ) with tubular connections and 8 lesions ( 13 .8% ) with irregular markly hypoechoic internal echoes . Two ( 3% ) were isoechoic .No calcification were found . Color Doppler signals were detected in 33 cases(56 .9% ) ,and the resistance index ( RI) ranged from 0 .61 to 0 .79 . Forty patients underwent mammography ,there were no distinct lesions in 6 cases(15% ) ,suspicious calcification in two(5% ) , asymmetric density in twenty(50% ) ,and solitary masses in twelve(30% ) . MRI was performed in 36 patients ,and revealed no abnormality in two patients(5 .6% ) , twenty nine lesions ( 80 .6% ) showed hypointensity on T1‐weighted images and hyperimensity on T2‐weighted images ,five lesions ( 13 .9% ) showed isointensity on T1‐weighted images and hyperimensity on T2‐weighted images ,and all the lesions showed heterogeneous enhancement after contrast .The diagnostic accuracy of ultrasonography , mammography and MRl was 63 .8% , 45% and 61 .1% , respectively . Conclusions There were no specific imaging characteristics of GLM ,the combination of ultrasonography , mammography and MRI might benefit the diagnosis of GLM .

Objective To investigate the clinical significance and correlation between RAR-βgene methylation and p53 gene mutation in bronchoalveolar lavage fluid(BALF)in non-small-cell lung cancer.Methods BALF samples from 85 lung cancer pa-tients(lung cancer group)and 70 cases(benign lung diseases group)with benign lung diseases were collected.RAR-βgene methyla-tion in BALF samples was detected by methylation-specific PCR (MSP),and p53 gene mutation was detected by PCR and DNA se-quencing method.Results The rate of RAR-βmethylation and p53 mutation in BALF in lung cancer were 49.4% and 36.5%,re-spectively.Both were higher than in benign lung diseases group(P <0.01).RAR-βmethylation rate(32.5%)of patients with TNM stages(Ⅰ+Ⅱ)(32.5%)was higher than the p53 mutation rate(12.5%)over the same stages (P <0.05).RAR-βmethylation rate and p53 mutation rate of patients with stages(Ⅲ+Ⅳ)were higher than those with stages(Ⅰ+Ⅱ)(P <0.01).p53 mutation rate in lung cancer patients with RAR-βmethylation was higher than those with unmethylated(P <0.01).RAR-βmethylation rate of lung cancer patients with p53 mutation was higher than those without p53 mutation(P <0.01).Conclusion Detection of RAR-βmethyl-ation and p53 mutation in BALF contribute to the diagnosis of lung cancer.

Objective To investigate the value of shear wave elastography (SWE)for differential diagnosis of benign and malignant thyroid nodules.Methods A total of 1 56 patients referred for surgery of thyroid nodules underwent standard ultrasound as well as elastography.The following characteristics of all the nodules were assessed:location,size,shape,margin,echogenicity,calcification and blood flow.The SWE elasticity indices of maximum (Emax),mean (Emean),minimum (Emin),and standard deviation (Esd) were automatically calculated by the US system.Thresholds were calculated by receiver operating characteristic (ROC ) curve analysis.The diagnostic performance of conventional US and SWE were compared.Histopathologic examination was used as the reference standard.Results Among a total of 1 56 nodules,1 1 8 were malignant and 38 were benign.SWE elasticity indices were significantly higher in malignant than in benign nodules (P ≤0.001 ).Sensitivity and specificity for predicting malignancy were 83.9%,92.1 % respectively using Emean with a threshold of 32.1 kPa,the specificity was significantly higher than using conventional ultrasound (P <0.05 ).Area under the ROC curve (Az)of Emean was highest (0.880,95% CI:0.81 7,0.943),however the differences were not significant(P >0.05).Conclusions SWE provides higher specificity for predicting malignancy without losing sensitivity.

Objective To investigate the effect of CD34+ stem cells seeded stent graft in venous system. Method Twelve mongrel dogs were randomized into 2 groups. Stent grafts covered with PTFE or Dacron were implanted into infrarenal vena cava through a delivery system. In each group, 4 stent grafts were seeded by autogenous bone marrow CD34+ cells, and 2 treated by autogenous blood only as control. The grafts were explanted at 2 weeks. Light and electron microscopy were used to examine endothelialization of neointima. CD34 and Ⅷ factor stain were applied to identify endothelial cells. Results All stent grafts were patent except for one Dacron stent without seeding. Light, electron microscopy, CD34 and Ⅷ factor stain demonstrated that confluent endothelial cells appeared on the neointima of seeded grafts. No endothelial cells were detected in the non-seeding grafts. Conclusions Rapid endothelialization of stent grafts can be achieved through bone marrow CD34+ cells seeding in venous systems.

Objective:Based on relevant database data analysis,to explore the correlation of the abnormal expression of EMT related factors and chronic obstructive pulmonary disease and its related non-small cell lung cancer.Methods: Based on some data sets of GEO in the NCBI database,to perform express analysis,survival analysis and correlation analysis.Results: ①Snai1 and other EMT related regulatory factors exist significantly higher expression in non-small cell lung cancer patients,and E-cadherin (CDH1) was showed significantly lower expression. ②A large number of COPD patients samples were analyzed,and some EMT-related molecules in patients with COPD also showed significant abnormal expression and consistented with the changes in patients with non-small cell lung cancer.Conclusion: The results showed that dysregulation expression of EMT related regulatory factors may have some correlation with disease progression of COPD patients through the EMT markers and their expression and correlation analysis in COPD patients.

Objective To analyze the ultrasonographic characteristics of breast cystic-solid lesions and to investigate the diagnostic value of BI-RADS breast imaging reporting and data system in this kind of disease Methods Imaging characteristics of 105 breast cystic-solid lesions of 93 patients were analyzed All the lesions were assessed by BI-RADS Histopathologic examination was used as the reference standard Results Among 105 lesions 57 54 3% were benign and 48 45 7% were malignant Differences in orientation shape margin calcification and vascularity were statistically significant between the benign and malignant lesions P < 0 05 whereas the echo pattern and the posterior acoustic feature did not show significant differences P >0 05).There were 5 1 predominantly solid mass,which appeared as solid mass with little dispersed or centralized cystic regions or solid mass with surrounding cystic regions,including 33 benign lesions and 1 8 malignant lesions.The area under the curves of ROC was 0.956 in this type.There were 25 lesions predominantly cystic,which had regular or irregular thick walls or septa,or had nodules protruding to the cystic component,including 1 1 benign lesions and 14 malignant lesions.The area under the curves of ROC was 0.753.There were 29 mixed solid-cystic mass,in which the solid component equaled to the cystic,including 13 benign lesions and 16 malignant lesions.The area under the curves of ROC was 0.887.The area under curves of ROC was 0.873 for the all breast cystic-solid lesions.The rates of malignant cystic-solid lesions in the three types had no significant difference(P >0.05).Conclusions Ultrasound is a useful tool for diagnosing breast cystic-solid lesions.The proportion of the cystic component is not helpful to differentiate malignancy from benignancy.

Aspergillosis, Allergic Bronchopulmonary ; diagnosis ; etiology ; therapy ; Humans

Objective To investigate the differentiatial diagnostic value of 99Tcm-methoxyisobutylisonitrile ( MIBI ) SPECT combined with localizable CT in the evaluation of oxygen intervention for suspicious lung lesions,and to establish a cost-effective imaging modality in the detection of malignant lung lesions.Methods From September 2008 to March 2009,47 consecutive patients with suspicious malignant lung lesions underwent 99Tcm-MIBI SPECT/CT prospectively. Patients with suspicious pneumonia were treated with antibiotics for about 4 d before imaging. All patients were cannulized with a nostril tube for oxygen inhalation before 99Tc-MIBI injection. SPECT combined with localizable CT of the chest was performed at 10 min and 2 h after 99Tcm-MIBI injection. The uptake ratios of lesion to contralateral normal lung parenchyma(early uptake ratio:EUR and delayed uptake ratio:DUR) were compared using independent-samples ttest. In addition,the diagnostic efficiency of uptake ratios of lung lesions was analyzed with receiver operating characteristic (ROC) curve. Results Forty-seven patients ( primary lung cancers:32,metastatic tumors of the lung:4,benign lung diseases:11 ) had 51 lung lesions,including 39 malignant and 12 benign lung lesions. The sensitivity,specificity,accuracy,positive predictive value (PPV),and negative predictive value (NPV) were 94.9% (37/39),83.3% ( 10/12),92.2% (47/51),94.9% (37/39) and 83.3% ( 10/12),respectively. The EUR of malignant lesions was 2.95 ± 1.16,whereas of benign lesions was 1.43 ±0.33. The DUR of the malignant lesions was 3.19 ± 1.74,whereas of benign lesions was 1.60 ±0.32. Both EUR and DUR were significantly different between malignant and benign lung lesions,respectively (t= -4.44,-3.12,respectively,both P＜0.01). The ROC curve showed that EUR value ≥1.625 provided the sensitivity of 97.4% (38/39) and specificity of 83.3% (10/12); DUR value ≥ 1.75provided the sensitivity of 94.9% (37/39) and specificity of 83.3% (10/12). Conclusion 99Tcm-MIBI SPECT combined with localizable CT imaging in oxygen intervention has a potential value in differentiating malignant from benign lung lesions.

Objective To study the tolerance to 188Re-1-hydroxy-1 ,1-ethylidene disodium phosphonate(HEDP) in patients with bone pain caused by osseous metastases. Methods Thirty-one patients(10with prostate cancer, 9 with breast cancer, 3 with lung cancer, 5 with liver cancer, 2 with rectal cancer, 1with esophageal cancer and 1 with renal cancer) received a single injection dose of 188Re-HEDP. The patients were divided into four groups according to the injection dose: 20 MBq/kg (6 patients), 30 MBq/kg(6 patients), 40 MBq/kg (9 patients), and 50 MBq/kg (10 patients). Haematological toxicity (WHO grading) of grade Ⅲ- Ⅳ was considered unacceptable. Vital signs and adverse effects after injection were recorded for 8 weeks. Blood counts were measured weekly during a period of 8 weeks. Biochemical parameters and electrocardiogram were assayed at week 4 and 8. Statistical analysis was performed for per-protocol (pp) population (t-test). Results Twenty-seven patients belonged to PP population with 5 in the group of 20 MBq/kg, 5 in the group of 30 MBq/kg, 8 in the group of 40 MBq/kg and 9 in the group of 50 MBq/kg.No obvious adverse effects and no significant change of vital signs, electrocardiogram, liver and renal function were found after injection. Alkaline phosphatase was slightly higher than baseline at week 4 and 8 after therapy, but the difference was not statistically significant. In the 20 MBq/kg group, reversible grade Ⅰ leucopenia was noted in 1 patient. In the 30 MBq/kg group, 2 patients showed reversible grade Ⅰ leucopenia including 1 alone with reversible grade Ⅲ thrombopenia. In the 40 MBq/kg group, reversible grade Ⅰ leucopenia and thrombopenia was observed in 1 patient and reversible grade Ⅱ leucopenia and thrombopenia in another patient. In the .50 MBq/kg group, 3 patients showed reversible grade Ⅱ leucopenia. The lowest level of thrombopenia was at week 4(143.5 × 109/L), leucopenia at week 6 (5.4 × 109/L) and anaemia at week 8(t = 3.1325, 3.3156, 3.4917, all P ＜ 0. 05 compared with baseline). At week 8, the mean level of platelet and leucocyte recovered to baseline. "Bounce pain" was found in 2 of 27 patients (7.41%).Conclusions The dose of 20 MBq/kg, 30 MBq/kg, 40 MBq/kg or 50 MBq/kg of 188Re-HEDP do not cause significant side effects on cancer patients with bone metastases, though there is a tendency that the haematological toxicity may increase as the dose of 188Re-HEDP increases.