Objective To explore the thoracic CT manifestations and pathologic basis of pulmonary Wegener granulomatosis (WG),in order to improve the diagnostic accuracy.Methods Eighteen patients with pulmonary WG confirmed by pathology were collected.All the patients underwent CT scan and enhanced scan with 64-slice volume CT.CT features and clinical symptoms were retrospectively reviewed.Results The pathological manifestations of 18 cases with pulmonary WG were miscellaneous,including necrotizing granuloma infiltrated with inflammatory cells,intrapulmonary vasculitis,parenchymal necrosis,hemorrhage of pulmonary alveolus,microabscess and so on.Thoracic CT manifestations:multiple nodules were seen in 7 cases,multiple masses were detected in 4 cases,cavitations showed in 10 cases,peripheral wedge-shaped shadows showed in 2 cases,ground-glass attenuation and consolidation showed in 2 cases,bronchial wall thickening in 2 cases,solitary pulmonary nodule or mass in 3 cases,pleural effusion was seen in 5 cases.All the nodules,masses and cavitations demonstrated inhomogeneous and ring enhancement on contrast-enhanced images.Some patients presented with varied kinds of the above lesions,which could transform each other and became more or less.Conclusions Pulmonary WG has many pathological manifestations,resulting in the variety of the thoracic CT manifestations.The main manifestations are multiple nodules and multiple masses,necrotic cavitations.The feeding vessel sign to a nodule or mass and ring-shade cavity are relatively characteristics to diagnose pulmonary WG.The correct diagnosis could be established on the bases of understanding of the special developments and pathology of the lesions.

Thyroid cancer has a high morbidity in recent years, especially papillary thyroid cancer (PTC). Though the prognosis of PTC is generally decent, metastatic lymph nodes(MLN) may exist at the time of clinical diagnosis in some patients, which are currently considered one of important risk factors for tumor recurrence. Conventional ultrasonography gray scale mode can evaluate the morphology, size, boundary, internal echo and flow mode of thyroid nodules and cervical lymph nodes. Combining with dynamic enhancement mode and quantitative parameter evaluation of contrast-enhanced ultrasound (CEUS), qualitative judgment and quantitative determination of nodules hardness with ultrasound elastography, cytopathology and molecular detection with ultrasound-guided fine needle aspiration cytology, the diagnosis of cervical MLN of PTC has been greatly improved. The advancements of ultrasonography in evaluation of cervical MLN of thyroid cancer were mainly reviewed in this article.

Objective　To discuss the surgical strategy for giant petroclival meningioma.　Methods　Retrospective analysis of operation and prognosis of 32 patients with petroclival meningioma with a diameter of more than 4.5 cm was carried out.The patients were divided into two groups: suboccipital retromastoid approach and skull base surgical presigmoid sinus approach. Duration of surgery, degree of tumor removal, and postoperative neurological complications were compared between the two groups.　Results　The percentages of radical and subtotal tumor removal in the two groups were not statistically significant. Less time of operations in the presigmoid sinus approach group and mild postoperative neurological sequelae in the suboccipital retromastoid approach group were observed. Karnofsky prognosis scale of the patients at the dismiss time was higher in the suboccipital retromastoid approach group (P＜0.01).　Conclusions　The degree of dissection of giant petroclival meningioma is correlated with tumor nature, blood supply, and adherence to the brain stem. Suboccipital retromastoid approach is suitable for giant petroclival meningioma. Total tumor removal should not increase neurological impairment; if radical dissection is impossible, the tumour may be reduced to less than 3 cm in diameter so as to achieve good results of postoperative radio therapy.

Objective　To discuss the surgical strategy for giant petroclival meningioma.　Methods　Retrospective analysis of operation and prognosis of 32 patients with petroclival meningioma with a diameter of more than 4.5 cm was carried out.The patients were divided into two groups: suboccipital retromastoid approach and skull base surgical presigmoid sinus approach. Duration of surgery, degree of tumor removal, and postoperative neurological complications were compared between the two groups.　Results　The percentages of radical and subtotal tumor removal in the two groups were not statistically significant. Less time of operations in the presigmoid sinus approach group and mild postoperative neurological sequelae in the suboccipital retromastoid approach group were observed. Karnofsky prognosis scale of the patients at the dismiss time was higher in the suboccipital retromastoid approach group (P＜0.01).　Conclusions　The degree of dissection of giant petroclival meningioma is correlated with tumor nature, blood supply, and adherence to the brain stem. Suboccipital retromastoid approach is suitable for giant petroclival meningioma. Total tumor removal should not increase neurological impairment; if radical dissection is impossible, the tumour may be reduced to less than 3 cm in diameter so as to achieve good results of postoperative radio therapy.

OBJECTIVETo investigate the best surgical approach for the removal of dumbbell-shaped trigeminal neurinomas (DSTNs).

METHODSThe clinical materials of 46 patients with DSTNs surgically treated were analysed retrospectively. The patients were divided into two groups. In the early group (1978 - 1984), a series of conventional intradural approaches were used, and in the late group (1985 - 2000), an epidural approach via the skull-base craniotomy was used.

RESULTSTotal tumor removal was achieved in 42% (5/12) of the early group and 85% (29/34) of the late group (chi(2) = 8.8, P < 0.01). Temporary and permanent cranial nerve morbidities were 63% and 47% (chi(2) = 3.4, P > 0.05) in the early group and 48% and 15% in the late group (chi(2) = 6.1, P < 0.05).

CONCLUSIONThe best microsurgical approach for the removal of DSTNs is epiduro-transduro-transtentorial approach via skull-base craniotomy. It is not necessary to resect the petrous apex.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Neurilemmoma ; surgery ; Neurosurgical Procedures ; Trigeminal Nerve Diseases ; surgery

Objective:Discussion MKK4 protein expression in nasopharyngeal carcinoma and -1044 A/T polymorphism correlation.Methods:90 patients with nasopharyngeal carcinoma , MKK4 protein expression was determined by immunohistochemical staining,polymerase chain reaction-restriction fragment length polymorphism ( PCR-RFLP ) to detect the gene -1044A/T sites monocytes nucleotide polymorphism.Results:MKK4 protein expression in nasopharyngeal carcinoma (-) was 24.4%(22/90),(+) was 15.6%(14/90),(++) was 34.4%(31/90),(+++) was 25.6% (23/90).Low expression (-/+) patients with a total of 36 cases,-1044AA genotype accounted for 22 cases (61.11%),AT genotype accounted for 12 cases (33.33%),TT genotype accounted for two cases (5.56%),AT+TT gene type accounted for 14 cases (38.89%).The patients with high MKK4 expression of 54 cases,of which accounted for 38 cases of AA genotype (70.37%),AT genotype accounted with 15 cases (27.78%),TT genotype accounted for one case (1.85%),AT +TT genotype accounted for 16 cases (29.63%).Low expression and high expression of T gene mutation occurs no significant ( Z=0.323 , P=0.747 ) .Conclusion: MKK4 protein expression correlated with -1044 A/T gene promoter polymorphisms was no significant correlation .

Purpose To study the expression of TMPRSS2, ERG and ETV1 in prostatic cancer and their clinical pathologic signifi-cance. Methods Tissue microarray and immunohistochemistry (MaxVision) were used to detect TMPRSS2, ERG and ETV1 expres-sion in 70 prostatic cancer tissues, 10 prostatic intraepithelial neoplasia tissues and 18 benign prostate tissues. Results There was no statistical significance on positive rate of the expression of TMPRSS2 among prostatic cancer tissues, prostatic intraepithelial neoplasia tissues and benign prostate tissues (P>0. 05). The positive rate (81. 4%) of ERG in prostatic cancer tissues was significantly higher than that in prostatic intraepithelial neoplasia tissues ( 30. 0%) and benign prostate tissues ( 0. 0 ) ( P <0. 05 ) . The positive rate (68. 6%) of ETV1 in prostatic cancer tissues was significantly higher than that in prostatic intraepithelial neoplasia tissues (50. 0%) and benign prostate tissues (22. 2%) (P<0. 05). There was no correlation among the positive rates of TMPRSS2, ERG and ETV1 in prostatic cancer tissues and age (P>0. 05). The expression of TMPRSS2, ERG and ETV1 was positively correlated to Gleason score and clinical stage (P<0. 05). TMPRSS2 had positive correlation with ERG (rs =0. 465, P<0. 01). TMPRSS2 had positive correla-tion with ETV1 (rs =0. 590, P<0. 01). ERG had no positive correlation with ETV1 (rs =0. 151, P>0. 05). Conclusion ERG and ETV1 are expected to become therapeutic targets for prostate cancer. Detecting TMPRSS2, ERG and ETV1 at the same time is helpful to diagnosis and differential diagnosis of prostatic cancer, which might be new molecule markers of prostate cancer.

【Objective】 To explore the expression of USP9X in platelets and its effect on platelet function. 【Methods】 The expression of USP9X in human and mouse was evaluated by PCR and Western blot. Platelets from young and old mice were separated and prepared, and the expression of USP9X was detected. USP9X inhibitos were used to assess the regulation of USP9X in platelet function, including aggregation, ATP release and spreading. Platelet lysates were collected in different time points to evaluate the change of phosphorylation of Akt in USP9X inhibitors treated platelets. 【Results】 Both human and mouse platelets expressed USP9X. Compared to the young mice, the old mice showed significantly enhanced expression of USP9X(P<0.05). To assess the effect of USP9X on platelet function, USP9X inhibitor was used to pre-incubate platelets for 30 min and platelet function were examined later. Results showed that USP9X inhibitor significantly decreased platelet activation including aggregation, ATP release and spreading(P<0.05). Compared to the control group, the inhibitor treated group showed a significant decrease in the spreading area after 45 minutes. The Western blot results showed a significant decrease in Akt phosphorylation levels of platelets in the USP9X inhibitor treated group. 【Conclusion】 Both human and mouse platelet express USP9X, and inhibition of USP9X decreased platelet function including aggregation, ATP release and spreading. USP9X can also influence the phosphorylation of Akt. The inhibitor of USP9X may become a potential therapeutic target for thrombosis intervention.

Adult ; Arteriovenous Malformations ; diagnosis ; surgery ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Young Adult