Objective To study the CT manifestations of metastatic lymph node of thyroid carcinoma. Methods CT appearances of metastatic lymph node of thyroid carcinoma proved by surgery and pathology in 108 patients were reviewed. Results Of these 108 cases, metastatic lymph nodes were located at superoir and middle internal jugular chain(n=76), inferior internal jugular chain and super clavicular region(n=86), tracheoesophageal groove(n=52), and superior mediastinum(n=17). Of 84 thyroid papillary carcinoma patients, the attenuation of metastatic lymph nodes were similar to that of normal thyroid gland(n=16), with cystic formations (n=24), intracystic high attenuation papillary-like nodules (n=18), and fine granular calcifications (n=11). Of 24 follicular carcinoma, medullary carcinoma, and clear cell carcinoma patients, 17 cases had significant homogeneous or heterogeneous enhanced nodes, and the attenuation was the same as primary or recurrent thyroid tumors. Conclusion For thyroid carcinoma, the most common locations of metastatic lymph nodes were internal jugular chain, tracheoesophageal groove, and superior mediastinum regions. Marked enhancement similar to normal thyroid gland, cystic formations with intracystic high attenuation papillary-like nodules, and fine discrete granular calcifications were the characteristic manifestations of metastatic lymph node of papillary carcinoma. Marked homogeneous or heterogeneous enhancement after contrast administration and the same attenuation as the primary or recurrent thyroid tumor were found in follicular carcinoma, medullary carcinoma, and clear cell carcinoma metastases.

Objective To investigate the pathologic basis of intrahepatic biloma formed in the patients with hepatocellulr carcinoma (HCC) after interventional treatment and to assess its clinical significance. Methods Three hundreds and fifty cases of HCC were followed up with CT examination after TAE/PEI, 11 cases received percutaneous bilomography, 10 cases received percutaneous biopsy, and 1 case had surgical resection. All cases of biloma underwent external drainage of bile or ethanol ablation. Results 11 cases of biloma were found (11/350), and all of them displayed a cystic dilation (11/11), 4 cases showed a columnar dilation with indefinite border (4/11), and 3 cases accompanied with a “soft rattan sign” of intrahepatic bile ducts (3/11). The pathologic findings included necrosis on the wall of the biliary tract, extravasation of bile, and infiltration with inflammatory cells. After the external drainage or the ethanol ablation, jaundice had been decreased and symptoms relieved (9/11). Conclusions Biloma is one of the complications of the patients with HCC after TAE/PEI caused by the necrosis of the wall of biliary tract, the correct diagnosis depends on the imaging procedures and biopsy. It is helpful to the further treatment to distinguish biloma from residual nidus of carcinoma. External drainage, stent placement, and ethanol ablation may be the choice of management.

Objective To retrospectively analyze diagnosis and treatment of chronic pancreatitis. Methods One thousand and seven hundreds patients with confirmed chronic pancreatitis in 21 hospitals were retrospectively studied,including their associated etiological factors,diagnostic and therapeutic methods.Results Among these patients,601 were alcoholic,576 were biliary diseases origin,which ac- counted for 35.4% and 33.9%,respectively.The most common symptom of chronic pancreatitis was abdominal pain.Some of patients accompanied by steatorrhoea and decreased body weight.Part of pa tients(239 cases)were diagnosed by histopathologic examination.Others were diagnosed by imaging techniques.Alleviation of symptoms was achieved with conservative management.Conclusions Alcohol consumption was the most common predisposing factor for chronic pancreatitis.Imaging techniques play the most important role in diagnosis of the disease,and non-operation managements were the main meth- ods for treatment of chronic pancreatitis.

Objective To explore and evaluate the clinical value of MRI for status of axillary lymph node after neoadju-vant chemotherapy (NAC) in patients with breast cancer. Methods Forty-four patients with 1ocally advanced breast cancer (LABC) were underwent NAC for four cycles. The longest diameter of axillary lymph node (ALN) measured by MRI scan. Val-ue of apparent diffusion coefficient (ADC) and their correlation were compared before NAC and four cycles after NAC. Re-sults of MRI and pathological data for ALN were compared between two groups of patients. Results All patients finished four cycles of NAC. The total response rate (CR+PR) was 72.7% (32/44), and the total non-response rate (SD+PD) was 27.3%(12/44). The longest diameter of ALN was significantly shortened in response group. The longest diameter was (1.37± 1.06) cm before NAC and (0.90±0.76) cm after NAC (P<0.01). The ADC value of the tumor was significantly increased in re-sponse group [(0.91±0.28) ×10-3 mm2/s before NAC and (1.01±0.32)×10-3 mm2/s after NAC, P<0.01)]. There was no signifi-cant correlation between ADC value change (△ADC) and the longest diameter change of ALN (△L, r=0.131, P=0.413). The sensitivity, specificity and Kappa value of ALN evaluation after NAC were 100%, 62.5%and 0.68 measured by MRI. Con-clusion The change of tumor longest diameter reflects the effect of chemotherapy directly. The tumor ADC value of MRI can not be used as an independent indicator of chemotherapy effect of ALN, eventhouth MRI was the sensitive index for eval-uating the status of axillary lymph node after neoadjuvant chemotherapy for breast cancer.

Objective To investigate the curative effect of arthroscopic treatment for lateral dis-cord meniscus tear in children. Methods The study involved 229 child patients with lateral discord meniscal tear treated arthroscopically from March 1996 to March 2008. There were 133 males and 96 fe-males, at age of (9±3.5) years (range 4-14 years). The treatment methods included meniscus-plasty in 219 patients (including two children with postoperative recurrence), meniscus-plasty-suture in eight and partial meniscectomy in two. The function of the knees was assessed pre-operationally and post-operation-ally by using Lysholm score. Results Of all, 221 patients were followed up for a period of (65±48.9) months (range 5-144 months). The pain and swelling were alleviated, with obvious improvement in range of motion and knee function in all patients six months after operation. There were no complica-tions including intra-articular infection, iatrogenic injury, fibroarthritis or loss of range of motion. Ly-sholm score was (61.85±7.65) points (range 45-73) before operation, which was improved to (95.30±3.50) points (range 87-100 points) six months after operation (t= 26.778, P < 0.01). Conclusion Treatment of lateral discord meniscus tear under arthroscopic guidance in children has the advantages of minor trauma, satisfactory results, can maintain good shape of the meniscus and good func-tion of knee and reduce incidence rate of osteoarthritis.

Objective We aimed to describe the application value of continuous glucose monitoring system in patients with advanced gestational diabetes mellitus (GDM). Methods Pregant women in the medium and late pregant phases (24～35 weeks) underwent GDM screen test from January 2006 to April 2007. They first received 50 g glucose challenge test and 100g OGTT was performed 3 days later when the blood glucose was higher than or equal to 7.8mmol/L. According to the diagnostic criteria from American Diabetes Mellitus (ADA) 47 women were diagnosed to possess GDM and they were further divided into the test group (25 cases) and the control group (22 cases). The test group received 72 hours continuous glucose monitoring (CGMS). The control group adopted peripheral blood glucose monitoring using blood from the fingertip, 7 times per day. Results There were no records of consciousness hypoglycemic symptoms and hypoglycemia during monitoring. The CGMS data suggested that the record of the percent of high blood glucose was (17.5±3.1)%, percent of low blood glucose was (2.4±0.9)%, which were higher than those of the control group, which were (14.3±2.2)% and 0. Conclusions We recommend pregant women with GDM to undergo CGMS while using peripheral blood glucose monitoring with blood from the fingertip. It could systemicly evaluate the real control condition of blood glucose and ensure the safety of both mothers and babies.

Radiation-induced brain injury is a neurological injury caused by radiation therapy of head and neck tumors. The pathogenesis is still unclear. It is hypothesized that immune cells play an important role in radiation-induced brain injury. The excessive activation of microglia in the central nervous system and the migration of peripheral immune cells into the brain collectively promote the incidence and development of radiation-induced brain injury. In this article, the immunological mechanism underlying the radiation-induced brain injury was reviewed.

Objective To explore the correlations between measurements of Doppler velocity waveform parameters of fetal main pulmonary artery and gestation age (GA) in normal fetus. Methods This is a cross-sectional study, in which totally 252 normal singleton fetuses between 23 and 40 weeks of gestation were divided into 10 groups. The following velocity waveform parameters were measured in the main trunk of fetal pulmonary artery by Doppler ultrasound: acceleration time(AT), ejection time(ET), acceleration time/ejection time(AT/ET), peak systolic velocity(PSV), end diastolic velocity(EDV), mean velocity(MV), pulsatility index(PI) and resistance index(RI). The normal reference values of Doppler velocity waveform parameters at various GA were established. A scatter diagram of each parameter against GA was plotted out. The optimal formula was selected out according to the correlation and regression analysis. Results Among 252 normal fetuses, satisfactory Doppler velocity waveform of fetal main pulmonary were achieved in 249 (98.8%, 249/252). Among these parameters, AT, AT/ET, PSV, EDV and MV increased with increasing GA(F=343.23, 96.012, 8.649, 2.158, 10.169, all P<0.05), while PI decreased slightly(F=2.346, P<0.05) and ET, RI had no signiifcant changing(F=0.883, 1.534, both P>0.05). Signiifcant and positive linear correlations were found between parameters of AT, AT/ET, PSV, EDV, MV and GA(r= 0.898, 0.868, 0.446, 0.203, 0.507, all P<0.01);while PI was inversely linear correlated with GA(r=-0.184, P<0.01) and ET, RI had no correlation with GA(r=-0.103, 0.011, both P>0.05). Conclusions The fetal main pulmonary artery could be a reliable sampling point to obtain pulmonary velocity waveform by Doppler ultrasound. Doppler velocity waveform parameters have correlations with GA in normal fetus;among which AT and AT/ET were the best.

Recently, microRNAs (miRNAs) have been shown to be involved in multiple biological pathways that can influence tumor progression and metastasis and they can serve as prognostic biomarkers in many cancers. The present study examined the prognostic significance of miR-215 in cervical cancer. The paraffin-embedded paired cervical scrape samples and tumor tissue samples from 302 patients with stage II cervical cancer were detected for the expression of miR-215 by using qRT-PCR. A miR-215-based classifier was established by using the Cox regression model. The prognostic and predictive accuracy of this classifier was determined in both the internal testing group of 138 patients, and the external independent group of 280 patients. Moreover, cervical cancer HeLa cells overexpressing miR-215 (HeLa-miR-215) were constructed and subcutaneously injected into the nude mice to examine the effect of miR-215 on tumor growth and metastasis in vivo. The results showed that the expression level of miR-215 was significantly higher in cervical cancer tissues than in paired normal tissues (P<0.0001). When patients were classified into high- and low-risk cancer progression groups according to miR-215 level, the 5-year disease-free survival in high- and low-risk groups were 43% (95% CI: 32.1-51.6) and 67% (95% CI: 48.6-77.3) (hazard ratio [HR] 2.02, 95% CI: 1.16-3.52; P=0.013) respectively. Moreover, the expression level of miR-215 was negatively associated with survival rate in patients at TNM stage T3 (HR: 3.317; 95% CI: 1.18-5.14, P=0.017) and TNM stage T4 (HR: 3.48; 95% CI: 1.49-4.45, P=0.008). Tumor volume in nude mice injected with HeLa-miR-215 cells was significantly larger than that in mice injected with control HeLa cells. It was concluded that the expression level of miR-215 is associated with cervical tumor progression and worse survival rate, suggesting that it may serve as a potential prognostic marker to identify patients at higher risk of recurrence.

0.05). However, egg production (0.37?0.22 egg/hen? day) and feed efficiency(0.21 ?0.11 egg kg/feed kg) in group 4(FSD) increased 54.2% and 61.5% respectively. The results from this study showed that egg cholesterol significantly decreased when laying hens were fed fiber-sequestrant.