Objective To analyze CT features of adrenal non-functional pheochromocytoma and non-functional adenoma and to provide reference for the diagnosis and differential diagnosis.Methods 17 cases of adrenal non-functional pheochromocytoma and 31 cases of non-functional adenoma confirmed by pathology were analyzed retrospectively.The imaging findings of two groups of cases were statistically analyzed, including size, shape, density, enhanced degree, visible tumor blood vessels, necrosis and cystoid variation and so on.Results The average diameter of the pheochromocytoma was (52.2±20.2) mm, and the average diameter of the adenoma was (27.8±17.6) mm, the difference was statistically significant (P<0.05).The average CT value of pheochromocytoma was higher than that of adenoma in plain, arterial and venous phases(all P<0.05).Of the 17 cases of pheochromocytoma, 14 cases (82.4%) can be seen tumor blood vessels in the arterial phase, 12 cases (70.6%) can be seen necrosis and cystoid variation, the margins of the tumors were no circular or arc-like enhancement;of the 31 cases of adenoma, 3 cases (9.7%) can be seen tumor blood vessels in the arterial phase, 2 cases (6.5%) can be seen necrosis and cystoid variation,10 cases (32.3%) can be seen circular or arc-like enhancement;all the differences were statistically significant (all P<0.05).Conclusion Adrenal non-functional pheochromocytoma and non-functional adenoma have characteristic imaging findings, dual phase enhanced scanning of MSCT is helpful for clinical diagnosis and treatment, one of the distinguishing points is to find tumor blood vessels in arterial phase.

Objective To analyze the application value of MSCT enhanced scanning in diagnosis of gastrointestinal mucoca associated lymphoid tissue(MALT) lymphoma.Methods 11 cases of gastrointestinal MALT lymphomas confirmed by pathology were analyzed retrospectively.The clinical data and imaging features of 11 cases were analyzed,including lesion sites, morphologic features and enhancement patterns of tumors,positions of lymph nodes,involvement of extranodal site excluding gastrointestinal tract.Results For morphologic features,8 cases (72.7%) were gastrointestinal wall thickening type, among them, 5 cases occurred in the stomach and 3 cases in the intestine;3 cases (27.3%) were localized mass/nodule type, among them, 2 cases occurred in the stomach and 1 case occurred in the intestine.The sign of aneurysmal dilatation was showed in 2 cases, which occurred in the intestinal tract.There was 1 case of localized mass/nodule MALT lymphoma in the ileocecal junction with local intestinal lumen stenosis.For the manifestations of enhanced scanning,10 cases (90.9%) of tumors were moderately or obviously enhanced, 9 cases (81.8%) showed homogeneous enhancement.For the involvement of lymph nodes and other extranodal organs, regional lymph nodes were involved in 5 cases(45.5%), regional lymph nodes and distant lymph nodes were involved in 1 case(9.1%), lymph nodes of both sides of the diaphragm were involved in 1 case (9.1%), extranodal sites excluding gastrointestinal tract were involved in 2 cases (18.2%).9 cases (81.8%) were classified as stage Ⅰ-Ⅱ, 2 cases (18.2%) were classified as stage Ⅳ.Conclusion MSCT enhanced scanning can provide a reliable basis for the diagnosis and staging of gastrointestinal MALT lymphoma.The chest and abdominopelvic cavity enhanced scanning is recommended as a routine examination.

Objective:The effect and side effect of the dose-adjusted EPOCH regimen were evaluated perspectively for the pre-liminarily diagnosed angioimmunoblastic T-cell lymphoma. Methods: Nine cases of untreated angioimmunoblastic T-cell lymphoma were diagnosed and enrolled in our department from September 2008 to September 2012. All patients received dose-adjusted EPOCH regimen as first-line chemotherapy. Results: The median age of 9 patients was 54 years. The male-to-female ratio was 2∶1. About 88.9%of all patients were at Ann Arbor stageⅢ/Ⅳ, and 77.8%presented with B symptoms. Anemia was found in 66.7%of 9 patients, and lactate dehydrogenase elevated in 55.6%of patients. After an average of 4.7 cycles of chemotherapy of dose-adjusted EPOCH regi-men, the complete remission rate was 22.2%, and the total response rate was 66.7%. With a median follow-up of 20 months, the 4-year progression-free survival rate was 11.1%, and the overall survival rate was 33.3%. The median survival time was 19 months. The most common adverse events of EPOCH chemotherapy were hematologic toxicity. Grades 3-4 neutropenia and thrombocytopenia were re-ported in 77.8%and 33.3%of patients. Febrile neutropenia was observed in 44.4%of patients. Non-treatment-related mortality was al-so noted. Conclusion: The results of our research showed no clear benefit of treating preliminarily diagnosed angioimmunoblastic T-cell lymphoma with dose-adjusted EPOCH regimen. The main adverse events were hematologic toxicity and could be tolerated.

Objective To analyze the clinical characteristics and recent curative effect of mantle cell lymphoma (MCL) after conventional treatment.Methods Clinical data of 15 MCL patients admitted in the Affiliated Hospital of Academy of Military Medical Sciences between August 2004 and October 2013 were retrospectively analyzed.Results The median age of those patients was 59 and the male to female ratio was 1.5∶1.Fourteen(93%)cases were in Ann-Arbor stages Ⅲ -Ⅳ, 15 cases (100%)primarily with lymph node involvement,7 cases (47%)with bone marrow involvement,4 cases (27%)with gastrointestinal involvement,and 3 cases (20%)with orbit involvement.Less than 40% expression of Ki-67 was observed in 9 cases (60%),while 6 cases were with more than 40% (40%).One case was blastic variant.First-line therapy was CHOP-like regimens,which were combined with rituximab in 8 of the 15 cases.In this study,the median survival time was 12 months (3 -64),and the overal response rate was 80%after induction chemotherapy.The current survival of 7 /9 cases with less than 40% expression of Ki-67 was 8 -64 months,2 /6 cases with more than 40% expression of Ki-67 was 8 and 9 months,respectively.Conclusion MCL mostly occurs in older males.Extranodal invasion is common in MCL as an aggressive tumor.The efficacy of traditional chemotherapy is currently limited.Blastic variant or high expression of Ki-67 is an adverse prognostic indicator.

Objective To analyze the effects of deep learning image reconstruction(DLIR)and adaptive statistical iterative recon-struction V(ASIR-V)on the imaging quality of chest CT in patient with pulmonary nodules,and to evaluate the differences based on different image reconstruction techniques in the detection of efficiency of computer-aided diagnosis(CAD)for pulmonary nodules.Methods The image data of pulmonary nodules of eighty patients with chest CT screening were reconstructed with ASIR-V 80％,DLIR-low(DLIR-L),DLIR-medium(DLIR-M)and DLIR-high(DLIR-H)images,respectively.The objective image quality and sub-jective image quality of the four groups were compared and analyzed.Objective image quality includes CT value of region of interest(ROI),noise,signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)and image average gradient.The diagnostic efficacy of CAD in detecting pulmonary nodules of reconstructed images among four groups were further evaluated.Results There were no signifi-cant difference in CT value of ROI of reconstructed images among the four groups(P＞0.05).The noise,SNR and CNR of DLIR-H images were similar to those of ASIR-V 80％(P＞0.05),but significantly better than those of DLIR-L and DLIR-M(P＜0.05).The average gradient of DLIR-L,DLIR-M and DLIR-H images were significantly higher than those of ASIR-V 80％(P＜0.05).The subjective image quality scores of DLIR-L,DLIR-M and DLIR-H images were significantly higher than those of ASIR-V 80％(P＜0.05),and the subjective image quality score of DLIR-H image was the highest.CAD showed the highest true positive rate in DLIR-H images for detecting pulmonary nodules(P＜0.05),and CAD showed the highest false positives per capita in ASIR-V 80％images for detecting pulmonary nodules(P＜0.05).Conclusion The noise,SNR and CNR of DLIR-H images are similar to those of ASIR-V 80％,with the significantly higher image clarity and subjective image quality scores.DLIR-H has advantages in CAD detection of pulmonary nodules,which is an ideal image reconstruction technology for chest CT pulmonary nodule screening.

This study aimed to identify the related substances of lorazepam tablets by liquid chromatography mass spectrometry (LC-MS). To separate the related substances of lorazepam tablets, gradient elution was performed using acetonitrile and 0.1% acetic acid -20 mmol/L of ammonium acetate as mobile phase on Inert Sustain C18 (250 mm × 4.6 mm, 5 μm).The accurate mass and elemental composition of the parent ions and their product ions of related substances were determined by electrospray-ionization quadrupole time-of-flight high resolution mass spectrometry (ESI-Q-TOF/MS).The structures of the related substances were identified by spectral analysis. Under the established analytical condition, lorazepam and its related substances were adequately separated, and 22 major related substances with content greater than 0.1% were detected and identified by hyphenated techniques in lorazepam tablets and their stressed samples.Among them, 5 were the impurities listed in the USP or EP, and the others were unknown related substances identified for the first time in this paper.The LC-MS technique can effectively separate and identify the related substances of lorazepam tablets, which provides some reference for quality control.

OBJECTIVETo observe the protective effects on acute myocardial infarction of QDYX in dog.

METHODThe corconary ciculation and cardial oxygen metabolism, the degree and range of myocardial ischemia, myocardial infarct size, and the changes of the enzymes in serum were determined by using the acute myocardial infarction model of ligation of LAD in the anaesthetized open-chest dogs.

RESULTThe coronary resistance and cardial oxygen consumption were decreased and the myocardial blood flow was increased in dogs treated with QDYX of 1.0,2.0 mg.kg-1. The degree and range of myocardial ischemia, myocardial infarct size and the activity of serum CK, LDH were decreased in acute myocardial infarcion dogs treated with QDYX of 1.0,2.0 mg.kg-1.

CONCLUSIONQDYX can decrease cardial oxygen consumption in dogs, thus having protective effect on myocardial ischemia.

Administration, Oral ; Animals ; Astragalus membranaceus ; chemistry ; Cardiotonic Agents ; administration & dosage ; pharmacology ; Coronary Circulation ; drug effects ; Dogs ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Female ; Male ; Myocardial Infarction ; pathology ; physiopathology ; Ophiopogon ; chemistry ; Plants, Medicinal ; chemistry ; Salvia miltiorrhiza ; chemistry

The aim of this study was to investigate the clinical characteristics and prognosis of acute erythroleukemia (AEL, AML-M6). The clinical features and results of morphologic, immunophenotypic, cytogenetic and molecular biologic detections were retrospectively analyzed in 13 cases of AEL from 305 acute leukemia patients hospitalized between October 2007 and October 2012. The results showed that the expression of erythroid and non-erythroid cells increased at the same time. The myeloid antigens mainly expressed CD13/CD33/CD117/CD34, while the erythroid antigens expressed Gly and CD71. The karyotypic detection indicated that there were 1 case with normal karyotype, 3 cases with simple karyotypic abnormality and 2 cases with complex karyotypic abnormality, the other cases were not detected. The molecular biological detection found that the poor prognosis gene existed in 5 cases [38.5% (5/13)], including 3 cases with MLL-MLL fusion gene, 1 case with MLL mutation, and 1 cases with NRAS gene mutation, the abnormal genes were not detected in remainder 8 cases. After chemotherapy with decitabine, the complete remission (CR) rate achieved 53.5% (7/13), partial remission (DR) rate achieved 15.4% (2/13). Finally, 8 patients received allo-HSCT, the median overall survival (OS) was 20.7 months, 3 year survival rate was 79%, 3 year disease-free survival rate was 78%. It is concluded that the acute erythroleukemia is a rare subtype of AML, which is transformed from MDS and has harmful genes and poor prognosis. Allo-HSCT and treatment with decitabine may enhance the survival rate of AEL.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Karyotyping ; Leukemia, Erythroblastic, Acute ; diagnosis ; genetics ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate ; Young Adult

This study was designed to compare the curative effect, prognosis and safety of different preconditioning regimens for patients who received autologous hematopoietic stem cell transplantation (AHSCT) for malignant lymphoma (ML). The clinical data of 100 ML patients (Sep 1992 to Aug 2010 in 307 Hospital) were retrospectively analyzed, and were divided into two groups by different preconditioning regimens: the high-dose chemotherapy preconditioning group and high-dose chemotherapy/radiotherapy preconditioning group. The overall survival (OS) rate, progress free survival (PFS) rate and adverse effect were analyzed. The results showed that until Feb 2011, the median follow-up was 33.5 months. All patients were engrafted and their hematopoiesis was reconstituted. The median time of WBC recovery up to > 1.0×1.0(9)/L in high-dose chemotherapy preconditioning group and high-dose chemotherapy/radiotherapy preconditioning group were (6.0 ± 0.4) d and (8.2 ± 0.4) d, platelet up to > 20.0×1.0(9)/L in two groups were (7.1 ± 0.8) d and (11.4 ± 2.5) d (P < 0.05). The 3-year OS rate of the two groups were 67.3% and 68.9%. 5-year OS rates of two groups were 62.8% and 60.6%, 10-year OS rates of two groups were 57.6% and 56.2% respectively; 3-year PFS of two group were 63.6% and 63.2%, 5-year of two group were 59.4% and 58.3%, 10-year of two group were 50.8% and 55.3% respectively (P > 0.05). Meanwhile, the incidence of fever, infection, bleeding, secondary cancer between two groups was not significant different (P > 0.05). It is concluded that the hematopoietic reconstitution of high-dose chemotherapy/radiotherapy preconditioning group is later than that of high-dose chemotherapy preconditioning group. However, there is no significant difference in curative effect and prognosis between the two groups.
Adolescent ; Adult ; Aged ; Child ; Combined Modality Therapy ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphoma ; surgery ; therapy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Transplantation Conditioning ; methods ; Transplantation, Autologous ; Young Adult

Objective To summarize the computed tomographic (CT) manifestations of pulmonary aspergillosis after organ transplantation and compare different signs between pulmonary aspergillosis and bacterial pneumonia.Methods CT images of pulmonary aspergillosis (n =62) and bacterial pneumonia (n =68) in post-transplantation patients were reviewed.The signs were categorized with consolidation,mass,large nodule (≥1crn),small nodule and bud-in-tree pattern.Some detailed useful differentiating signs such as halo sign,air bronchogram sign,reversed halo sign,hypodensity sign and cavitation were also analyzed.Results CT patterns of pulmonary aspergillosis included consolidation,mass,large nodule,small nodule and bud-in-tree pattern.The most common was large nodule (75.8％),followed by consolidation (48.4％)and mass (29.0％).And small nodule (16.1 ％) and bud-in-tree (12.9％) patterns were concurrent.For consolidation pattern,the proportion of bacterial pneumonia (69.1％) was the larger;For mass pattern,the proportion of pulmonary aspergillosis (29.0％) was the larger.For large nodule pattern,there was no difference.The detail sign of large nodule in two groups had no difference In detailed signs of consolidation pattern,air bronchogram sign was more often seen in bacterial pneumonia while cavitation was more frequently found in pulmonary aspergillosis.In detailed signs of mass pattern,pulmonary aspergillosis often has single lesion (66.7％),cavitation (83.3％)and air crescent sign (77.8％) is more common.The proportion of halo sign was 30.7％.Conclusions CT manifestations of pulmonary aspergillosis are diverse after organ transplantation.There is some difference and yet overlap with bacterial pneumonia.