Purpose To explore the diagnostic value of dynamic contrast-enhanced CT (DCE-CT) in the differential diagnosis of chromophobic renal cell carcinoma (CRCC) and renal oncocytoma (RO). Materials and Methods A retrospective study was carried out on the DCE-CT findings of 24 patients with pathologically-proved CRCCs and 17 patients with pathologically-confirmed ROs. The enhancement percentage (EP) and the enhancement index (EI) of both types of lesions were compared on corticomedullary phase and nephrographic phase. Results CRCCs on corticomedullary phase and nephrographic phase:EP (132.8±39.8)%and (99.2±32.5)%, respectively;EI 0.31±0.11 and 0.30±0.12, respectively. ROs on corticomedullary phase and nephrographic phase:EP (234.1±129.1)%and (195.4±87.1)%, respectively;EI 0.66±0.33 and 0.68±0.28, respectively. Both EP and EI of CRCCs and ROs showed statistical difference (P<0.05). As the threshold value of EI on nephrograhic phase was 0.44, the sensitivity was 82.4%, specificity was 91.7% and Youden index was 0.74. Conclusion Imaging features of DCE-CT, especially EI on nephrographic phase, are helpful in the differential diagnosis of CRCC and RO.

Hepatocelular carcinoma ( HCC) is one of the most common causes of cancer death worldwide. Although surgical resection offers a better curative option than nonsurgical treatments, it is not an option for the majority of patients with poor hepatic function or at an advanced stage when diagnosed.Transcatheter arterial chemoembolization (TACE) is an alternative and effective nonsurgical treatment for HCC. Evaluation of the effect of TACE is important to develop a best therapeutic strategy. From January 2009 to December 2010, 28 patients with HCC received TACE at the PLA General Hospital, and the results of magnetic resonance imaging ( MRI) were analyzed. Fifty-one lesions were detected and the maximum diameter of the lesions was 14.7 cm. Twenty-eight lesions in 16 patients which showed variable signal intensity on T1- and T2 -weighted images and iso- or hypointensity on diffusion-weighted image ( DWI) had no enhancement. Five lesions of 10 tumors in four patients had focal enhancement in the first MRI after TACE that displayed hyperintensity on DWI. Eight patients had been found with tumor recurrence or metastasis when they received MRI for the second time. The recurrent, residual and intrahepatic metastatic tumors enhanced rapidly at dynamic early phase scanning and demonstrated hyperintensity on T2 -weighted images.

Pancreatic neuroendocrine neoplasms (pNENs) are rare tumors with malignant potential.The pNENs could be classified into functional or nonfunctional according to associated clinical symptoms.Magnetic resonance imaging (MRI) is helpful for preoperative diagnosis of nonfunctional pNENs.The clinical data of 22 patients with nonfunctional pNENs who were admitted to the Chinese PLA General Hospital from March 2010 to February 2014 were analyzed retrospectively.Nonfunctional pNENs were characterized by moderate to marked,consistent or progressive enhancement with capsule-like enhancement on dynamic contrast MRI,which is very important for the diagnosis and differential diagnosis of pNENs.

Objective To evaluate the feasibility of prospective electrocardiogram(ECG)-gating computed tomography coronary angiography(CTCA).Methods Sixty patients with suspected or known coronary artery disease underwent 64-slice CTCA using prospective ECG-gating.Multi-planar reconstruction (MPR),curved-planar reconstruction(CPR),maximum intensity projection(MIP)and volume rendering (VR)were used to demonstrate the coronary arteries.The image quality and radiation dose was evaluated.Results The mean effective radiation dose was(2.7±0.2)mSv.93.3%(720/772)segments of all coronary arteries were of diagnostic image quality,44.2%(341/772)Was classified as excellent and 49.1%(379/772)was good.Non-diagnostic coronary segments were found in 6.7%(52/772)of all coronary arteries.Therewere 5(8.3%)cases with severe coronary stenosis(＞75%)or occlusion,17(28.4%)cases with moderate stenosis(50%-75%),18(30.0%)cases with mild stenosis(＜50%)or irregular lumen,20(33.3%)cases with normal coronary artery.Conclusion With a low radiation dose,prospective electrocardiogram(ECG)-gated coronary 64-MSCT angiography has a good potential for the detection of coronary stenosis,especially for excluding coronary artery disease.

Objective To investigate the distribution and antimicrobial resistance of gram-negative bacilli isolated from wound specimens of orthopedic patients,and provide reference for the rational use of antimicrobial agents. Methods 682 isolates of gram-negative bacilli were collected from orthopedic department in a comprehensive hospi-tal between January 2011 and December 2013, antimicrobial susceptibility testing results were analyzed. Results The main gram-negative bacilli isolated from wound specimens of orthopedic patients were Pseudomonas aeruginosa (P .aeruginosa)(16.72%),Escherichia coli (E.coli)(15.40%),and Enterobacter cloacae (E.cloa-cae)(12.76%).The detection rates of extended-spectrum beta-lactamase-producing E.coli and Klebsialla pneu-moniae (K .pneumoniae)were 54.29%(57/105)and 31 .43% (22/70)respectively,and mainly distributed in the trauma orthopedic department,accounting for 49.12% and 45.45% respectively.The susceptibility rates of E.coli, K .pneumoniae ,and E.cloacae to meropenem and imipenem were all 100.00%.The susceptibility rates of E.coli and K .pneumoniae to amikacin,piperacillin-tazobactam and amoxicillin/clavulanic acid were all >80%.Suscepti-bility rate of E.cloacae to most antimicrobial agents were 71 .26% -100.00% except for piperacillin(64.37%). Susceptibility rates of P .aeruginosa to most antimicrobial agents were >85% except for cefepime (78.95%)and aztreonam (65.79%).Conclusion Gram-negative bacilli are the most common pathogens in wound infection of or-thopedics patients.In order to use antimicrobial agents rationally and improve clinical treatment effect,it is impor-tant to realize the distribution of pathogens and antimicrobial resistance.

Bis-A-S-TDA;This may be due to the presence of different active groups in the four compounds.

Objective To establish a rapid and sensitive method for detection of urinary protein.Methods In B-R buffer solution with pH 4.2,the signals of resonance light scattering by Poncesu S (PS) combined with protein in ?ex=?em=306nm were detected.Results There was a linear relation between the scattering signals of resonance light,and the protein concentration ranged from 0 to-1500 mg/l. The regression equation was ?I=2.24c-0.41,r=0.999 and the detection limit was 1.48 mg/l. The average recovery was 102.8% and the between-and within-subject coefficients of variation were 2.09% and 5.40% respectively.No significant difference was found compared with the method of PS.Conclusion The established method in this study is a simple,rapid and high sensitive method for determination of urinary protein.

Purpose To investigate CT and MRI manifestations of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusions (abbreviation as Xp11.2 translocation renal cell carcinoma).Materials and Methods Eighteen cases of Xp11.2 translocation renal cell carcinoma confirmed by pathology were retrospectively analyzed.Ten patients underwent CT scans,2 of them had unenhanced CT and 8 of them had pre-and post-contrast CT scan.Fourteen cases underwent plain and multi-phase contrast MRI scan,including 2 cases with unenhanced CT and 4 cases with pre-and post-contrast CT scan.The location,size,shape,density/signal,blood supply and the enhancement of the Xpl 1.2 translocation renal cell carcinoma were analyzed.Results All of the 18 tumors located in the corticomedullary with 17 solid lesions and 1 cystic lesion.The mean maximum diameter of the tumor was (4.6±2.0) cm.Thirteen lesions were circular or oval and 5 were irregularly or lobulated lesions.Ten lesions showed slightly high or high density on unenhanced CT,and the average CT value was (50.6± 11.5) HU,in which 4 lesions showed calcification.Among 8 cases of enhanced CT,1 lesion showed abundant blood supply,while 7 lesions showed lack of blood supply.Fourteen cases of MRI scan exhibited various imaging features with short T1 and T2 signal,and the persistent enhancement in the medullary phase.The MRI findings were further divided into 3 types according to the signal intensity and blood supply except 1 cystic lesion:① 5 lesions predominantly with short T1 and T2 signal were lack of blood supply;② 4 lesions predominantly with slightly longer T1 and T2 signal were abundant blood supply;③ 4 lesions predominantly with equal T1 and T2 signal were relatively lack of blood supply.Conclusion The CT and MRI features of Xpl 1.2 translocation renal cell carcinoma had certain manifestations:slightly high or high density nodule or mass located in corticomedullary on pre-contrast CT scan,various signal intensity with short T1 and T2 signal on MRI,and the persistent enhancement in the medullary phase.These image features combined with clinical data are helpful for diagnosis.

Objective To investigate the value of diffusion-weighted magnetic resonance imaging in the differential diagnosis of primary gallbladder cancer with liver invasion and primary hepatocellular carcinoma (HCC) with gallbladder invasion. Methods From January 2009 to October 2010, 11 patients with primary gallbladder cancer and 19 patients with primary HCC were admitted to the PLA General Hospital. The clinical data of the 30 patients were retrospectively analyzed. All patients underwent diffusion-weighted magnetic resonance imaging with b value of 800 s/mm2, and the receiver operating curve (ROC) was drawn. The apparent diffusion coefficient (ADC) values of the patients with gallbladder cancer and HCC were compared by independent sample t test. Results Thirty tumors were detected in the 30 patients. All tumors showed high signal on DWI, slightly low signal on T1 WI and slightly high signal on T2 WI. The foci of 11 patients with primary gallbladder cancer were at the gallbladder fossa, and 10 of them had liver involvement. The mean ADC value of the 11 patients was (0.89 ±0. 14)mm2/s. Of the 19 patients with primary HCC, the foci of 15 patients were at the right lobe of liver, and 4were at the left lobe. The mean ADC value of the 19 patients was (1.04 ±0.18)mm2/s. There was a significant difference in the ADC value between patients with primary gallbladder cancer and those with primary HCC ( t =2.425, P＜0. 05). The area under the ROC was 0. 756 (95% confidence interval: 0.577-0. 935), and the sensitivity and specificity were 68.4% and 81.8%, respectively, when the threshold value was 0.96 mm2/s.Conclusion The ADC value of patients with primary gallbladder cancer is lower than those with primary HCC when the b value is 800 s/mm2, which is helpful in the differential diagnosis of primary gallbladder cancer and primary HCC.

Objective To evaluate the efficacy and safety of focused ultrasound ablation in the treatment of submucosal fibroids which broke into uterine cavity less than 50%. Methods From Oct. 2006 to Sept. 2009, 66 patients with 69 submucosal fibroids broke into uterine cavity less than 50% diagnosed by MRI in Chinese People's Liberation Army General Hospital were enrolled in this study. They were treated by ultrasound-guided focused ultrasound ablation in the outpatient department, which using the contrast enhanced ultrasonography to assess the efficacy after ablation immediately, to measure reduction of fibroids volume and record adverse effect before and after ultrasound ablation. At 3, 6, 12 and 24 months after treatment, ablation outcome and fibroids volumes were evaluated by contrast ultrasound. The changes of clinical symptom were evaluated by the symptom severity score ( SSS) of the uterine fibroid quality-of-life instrument( UFS-QOL). Results The average volume of fibroids in 66 patients with 68 submucosal fibroids were (151 ±134) cm3 before treatment and (114 ± 104) cm3 no enhanced regional after treatment. The ablation rate of target fibroids was (77 ±16)%. All patients completed this treatment successfully, they were followed up for 6 - 44 months, the median follow-up time was 24 months. No serious complication was observed. However, there were 52% (34/66) patients presented vaginal discharge after ablation, it disappeared gradually after 3 to 4 menstrual cycles. The SSS and the menstrual period symptom scores were significantly lower than that before ablation at the follow-up of 3,6, 12 and 24 months, the rates were 20. 9% , 38. 0% , 45. 1% , 47. 1% and 42. 0% , 63. 8% , 64. 2% , 68. 8% , which all reached statistical difference (P ＜ 0. 05 ). The necrotic fibroids were absorbed gradually, the reduction rates of fibroid volume were 44. 7% ,66. 0% ,77. 7% and 89. 8% . Conclusion It was safe and efficacy that focused ultrasound ablation was used in treatment of submucosal fibroids which broke into the uterine less than 50%.