ObjectiveTo investigate the effect of different reference vessel groups on CT perfusion in patients with nasopharyngeal carcinoma (NPC) after radiation therapy,and explore the feasibility of substitution of reference vessel.MethodsThirty patients with NPC after radiation therapy were divide into two groups,recurrence group ( n =19) and fibrosis group ( n =11 ).All patients underwent CT perfusion scans,and the CT parameters were calculated with different arterial input and vein output in order to study their differences.The vessels were internal carotid artery-internal jugular vein( ICA-IJV group),external carotid artery-retomandibular vein (ECA-RTV group)and external carotid artery-internal jugular vein( ECAIJV group) respectively.The differences of the CT parameters between local recurrence group and fibrosis group were compared among the various vessel groups by rank sum test.With the help of receiver operating characteristic curve (ROC),the diagnostic efficiencies were compared by the area under the ROC curve (AUC).ResultsIn ICA-IJV group,ECA-RTV group and ECA-IJV group,bloood flow(BF) of local recurrence group were 201.88,439.59,252.23 ml · min-1 · 100 g-1,while BF of fibrosis group were 98.96,180.50,106.55 ml · min-1 · 100 g-1.Blood volume (BV) of local recurrence group were 6.71,12.39,6.70 ml/l00 g,while BV of fibrosis group were 2.35,4.76,2.95 ml/100 g.Mean transit time (MTT) of local recurrence group were 1.66,1.50,1.56 s,while MTT of fibrosis group were 2.13,1.96,1.79 s.Permeability surface (PS) of local recurrence group were 19.31,36.39,15.22 ml · min- 1 ·100 g-1,while they were 16.58,29.08 ,16.63 ml · min-1 · 100 g-1 in the fibrosis group.The differencesof BF and BV between the local recurrence group and fibrosis group were statistically significant in each vessel group (P ＜ 0.05 ) but MTT and PS showed no significant difference( P ＞ 0.05 ).In ICA-IJV group,the AUC of BF,BV,MTT,PS were 0.909,0.947,0.677,0.703,respectively.BF,BV,MTT,PS in ECA-RTV group were 0.938,0.967,0.648,0.679 respectively,and those in ECA-IJV group were 0.861,0.890,0.641,0.656 respectively.However,AUC of BF and BV of three groups all had significant difference ( P ＜ 0.01 ).ConclusionsBoth BF and BV values calculated by three pairs of reference vessels had enough diagnosis efficiency for local recurrence and fibrosis,so all of the three groups of vessels may substitute each other in CT perfusion.

0.05).Conclusion The parameters of CT perfusion can be regarded as a surrogate index of tumor angiogenic activity pre-and post-radiotherapy in nasopharyngeal carcinoma.

Objective To evaluate the diagnostic performance of enhancement value and morphological features by using mul-tiphasic MDCT on differentiating untypical T4a from T3 gastric cancer.Methods Fifty-one histopathologically proven T3 and T4a gastric cancer patients with smooth serosa were collected retrospectively.Three radiologists read all images regarding morphological features,while the CT value and enhancement value of regions of interest (ROIs)located in the outer of lesion were calculated.Cut-off analysis was performed to determine optimal threshold levels of enhancement value to discriminate T4a and T3 gastric cancer.Di-agnostic performance of enhancement value and combination of enhancement value and morphologic assessment were compared with morphologic assessment by means of receiver operating characteristic (ROC)curve analysis.Results The sensitivity and specificity of morphological features was 66.67% and 33.33% respectively;the area under the ROC of enhancement value (between venous phase and plain scan)for differentiating T4a from T3 gastric cancer was 0.82,with a cut-off at 43.6 HU,sensitivity of 74.07% and specificity of 70.83%.Combined conventional standard and enhancement value,sensitivity of 100.00% and specificity 26.31%. Conclusion For differentiation of T4a and T3 gastric cancer by means of MDCT,enhancement value is found to be superior to con-ventional standard.

Objective To study the diagnostic value of 1.5T diffusion-weighted magnetic resonance imaging for small metastatic cervical lymph nodes of nasopharyngeal carcinoma(NPC),and to explore the optimal diagnostic threshold value of apparent diffusion coefficient(ADC)in small metastatic cervical lymph nodes of NPC.Methods 40 patients with histopathologically confirmed NPC were underwent conventional,enhanced and DWI MR.The mean ADC value of large metastatic cervical lymph nodes group,small metastatic cervical lymph nodes group and benign lymph nodes group were measured respectively.Statistical analysis was done by using the SPSS 1 6.0 program software.The receiver operating characteristic (ROC)curve was performed to obtain the ADC thresh-old value of small metastatic cervical lymph nodes and the diagnostic efficacy.Results The mean ADC value of large metastatic cer-vical lymph nodes group was (0.74±0.1 1)×10 -3 mm2/s,which was not significantly different from that in small metastatic cervical lymph nodes group(0.75±0.13)×10 -3 mm2/s,P >0.05.The mean ADC value in benign lymph nodes group was (1.05± 0.18)× 10 -3 mm2/s,which was significantly higher than that in large metastatic cervical lymph nodes group and small metastatic cervical lymph nodes group(P <0.05 ).Using a threshold ADC value of 0.908 × 10 -3 mm2/s for differentiating small metastatic cervical lymph nodes from benign lymph nodes,a sensitivity of 83.2% and specificity of 90.9% were obtained,the area under the ROC curve was 0.92.Conclusion DWI is helpful in the diagnosis of small metastatic cervical lymph nodes of NPC.

Objective Compare the efifcacy and safety of drug eluting stent (DES) for treatment of in stent restenosis (ISR) and coronary de novo lesions. Methods Patients treated with DES for ISR and de novo lesions in Beijing Anzhen Hospital between October 2008 and December 2011 were followed up for 1 year. All lesions were divided into ISR and de novo group. Major adverse cardiovascular events (MACE) including all-cause death, myocardial infarction (MI) and clinical target lesion revascularization (TLR) were the primary endpoints. Results The study population consisted of 204 patients in the ISR group and 494 patients in the de novo group. Baseline clinical and angiographic parameters were comparable between the two groups. The rate of diabetic was higher in the ISR group than that in the de novo group (36.6%to 27.1%, P < 0.05). The diameter of coronary artery was smaller in the ISR group than that in the de novo group (2.72±0.36 to 3.08±0.54, P<0.01). The rate of TLR in the ISR group was higher than that in the de novo group (10.7%to 17.2%, P<0.05;14.2%to 21.1%, P<0.05),contributing to higher MACE in ISR group. Conclusions DES implantation is safe and effective for treatment of ISR lesions, but the rate of TLR is higher compared to treatment of de novo lesions.

Objective To evaluate the value of differential diagnosis between benign and malignant thyroid lesions by susceptibility weighted imaging(SWI).Methods 53 patients with 20 malignant thyroid lesions and 71 benign thyroid lesions confirmed by surgery and pathology were analyzed retrospectively.All cases received conventional MRI and SWI preoperatively.Location,volume,SWI parameters including signal to noise ratio(SNR),contrast noise ratio(CNR)and intratumor susceptibility hypointensity (ITSHIA)datas in benign and malignant lesions were compared and analyzed.Results There was no statistical significance between benign and malignant thyroid lesions in the location,volume,SNR and CNR(χ2 or t =0.014,0.286,0.927,1.169;P =0.907,0.778,0.368,0.259 respectively).The maximum diameter (1.90 mm±0.32 mm),degree of maximum diameter(1.33±0.47),frequence(1.40±0.20)and area ratio(1.09±0.28)for benign thyroid lesions were less than those for malignant lesions(3.39 mm±0.79 mm,2.25±0.44,1.40±0.68,1.70±0.47)respectively (t or Z =12.629,5.788,3.41 5,5.795;P =0.000,0.000,0.001,0.000).Conclusion SWI semiquantitative assessment of pathlogical vascularity is useful in differential diagnosis of benign and malignant thyroid lesions.

Objective To explore the value of the molecular probe USPIO-PEG-sLeX on nasopharyngeal carcinoma xenograft in nude mice.Methods The USPIO nanoparticles was synthesized by physical deposition method,and which was modified by PEG to synthesize USPIO-PEG-sLeX .The nude mice of nasopharyngeal carcinoma xenograft were divided into experimental and control groups.USPIO-PEG-sLeX and USPIO-PEG were injected into nude mice of experimental and control groups by caudal vein,respectively.MR T2 mapping imaging was scanned before and after the injection,and analyzed the changes of T2 values between experimental and control groups. Results USPIO-PEG-sLeX had a good representation.The non-enhanced T2 values between control and experimental group had no statistical significance (P >0.05).However,T2 values of the mice in two groups before and after injections were statistically significant (P <0.05);and T2 values of experimental group were much lower than that of the control group after the injection,additionally,the difference of enhanced rate between the two groups was statistically significant (P <0.05).Conclusion USPIO-PEG-sLeX magnetic nanoparticles is potential to be a targeted contrast agent to ELAM-1 expression of nasopharyngeal carcinoma,and can be valuable in non-invasive dynamic monitoring the expression of ELAM-1.

Objective To compare the effects of fixations with dynamic hip screw (DHS),percutaneous compression plate (PCCP) and proximal femoral nail anti-rotation (PFNA) for treatment of intertrochanteric femoral fractures with paries medialis defect.Methods We reviewed the 82 patients with femoral intertrochanteric fracture and paries medialis defect who had been treated at our department from January 2011 to July 2016.They were 42 men and 40 women,aged from 27 to 91 years (average,73.0 years).According to the AO classification,72 cases belonged to type 31-A2.2,10 to type 31-A2.3.Of them,9 cases were treated with DHS,17 cases with PCCP and 56 cases with PFNA-1].The 3 groups were compared in terms of intraoperative blood loss,blood infusion,fluid infusion,operation duration,time for fracture union,postoperative complications and Functional Recovery Score (FRS) of the hip 12 months after operation.Results The fluid infusion [1,100 (850,1,100) mL] and intraoperative blood loss [60 (5,100) mL] in the PCCP group were significantly less than in the PFNA group [1,100 (1,000,1,700) mL and 150 (50,300) mL] and the operation duration (91.4 ± 29.2 min) in the former was significantly shorter than in the latter [121 (85,185) min] (P ＜ 0.05).No significant difference was found between the 3 groups in blood infusion (P ＞ 0.05).Of the patients,57 (8 DHS,12 PCCP and 37 PFNA ones) were followed up for an average of 47 months (from 15 to 85 months).There were no statistically significant differences between the 3 groups in time for fracture union,complications,or average FRS score of the hip 12 months after operation (P ＞ 0.05).Conclusions For unstable intertrochanteric fractures with paries medialis defect,it is not clear that intramedullary nails are superior to extramedullary fixation.Intramedullary nails like PFNA may be suggested for patients with better preoperative conditions while extramedullary fixation like PCCP suggested for those with poor general conditions.

Objective To analyze the MRI findings of pure mucinous breast carcinoma and to investigate the causes of misdiagnosis.Methods MRI findings of 1 3 patients with pure mucinous breast carcinoma were analyzed retrospectively.All patients were verified by surgery and histopathology.Results All the 13 cases were presented as a mass,among which 12 cases (92.3%)had lobular contour and 1 (7.7%) had irregular shape.11 cases (84.6%)showed low or iso-signal intensity and 2 (15.4%)showed heterogeneous iso or high intensity on T1WI.All the 13 cases showed high signal intensity on fat suppression T2WI,and 5 cases(38.5%)showed low signal fiber separation inside. 5 cases (38.5%)showed homogeneous high signal intensity and 8 cases (61.5%)showed heterogeneous high signal intensity on diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)map,the ADC value was (2.002±0.478)× 10-3mm2/s.11 cases (84.6%)showed rim enhancement,among which 8(61.5%)showed persistent enhancement and 2 (15.4%)showed heterogeneous enhancement.Time-signal intensity cure(TIC)of 11 cases(84.6%)were monophasic or biphasic and 2 cases(15.4%0)were wash-out type. 5 cases(38.5%)were misdiagnosed on preoperative MRI.Conclusion There are several MRI features in pure mucinous breast carcinoma,such as lobular contour,high signal intensity on DWI and ADC map,persistent enhancement and monophasic or biphasic on TIC.Comprehending these MRI features is the key to reduce misdiagnosis.

Background and Objectives: Adipose tissue-derived mesenchymal stem cells (ASCs) are recognized as an advantaged source for the prevention and treatment of diverse diseases including type 2 diabetes mellitus (T2DM). However, alterations in characteristics of ASCs from the aforementioned T2DM patients are still obscure, which also hinder the rigorous and systematic illumination of progression and pathogenesis. Methods: and Results: In this study, we originally isolated peripancreatic adipose tissue-derived mesenchymal stem cells from both human type 2 diabetic and non-diabetic donors (T2DM-ASCs, ND-ASCs) with the parental consent, respectively. We noticed that T2DM-ASCs exhibited indistinguishable immunophenotype, cell vitality, chondrogenic differentiation and stemness as ND-ASCs. Simultaneously, there’s merely alterations in migration and immunoregulatory capacities in T2DM-ASCs. However, differing from ND-ASCs, T2DM-ASCs exhibited deficiency in adipogenic and osteogenic differentiation, and in particular, the delayed cell cycle and different cytokine expression spectrum. Conclusions The conservative alterations of T2DM-ASCs in multifaceted characteristics indicated the possibility of autologous application of ASCs for cell-based T2DM treatment in the future.