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.

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.

Objective To document the MRI features of renal angiomyolipoma (RAML) containing minimal fat and to explore whether the MR features vary depending on the tumor size. Methods The MR findings of 15 cases of pathologically-proved RAML containing minimal fat were reviewed retrospectively from January 2008 to March 2010. All patients underwent MR in a 1.5 T or 3.0 T scanners. The MR features of the lesions were analyzed, with emphasis on the signal intensity and homogeneity on T2WI, in regards to pseudocapsule, lipid component, hemorrhage, cystic degeneration or necrosis, blood vessels, interface with renal parenchyma and enhancement pattern. All lesions were categorized into 2 groups; those with diameter ＞4 cm and those with diameter ≤4 cm. The difference of imaging characteristics between these two groups was analyzed using Fisher exact test. Results All 15 lesions demonstrated hypointensity on T2WI compared to the renal parenchyma. Homogeneous signal intensity on T2WI was seen in 6 lesions (6/15); peritumoral pseudocapsule in 3 lesions (3/15); cystic degeneration or necrosis, hemorrhage in 5 lesions (5/15); flow void of blood vessels in 2 lesions (2/15); lipid component in 4 lesions (4/15); angular interface with renal parenchyma in 10 lesions (10/15); homogeneous enhancement in 8 lesions (8/15). Fifteen lesions were divided into two groups; 9 categorized into group 1 (the maximum diameter ≤ 4 cm) and 6 into group 2 ( the maximum diameter ＞ 4 cm). Cystic degeneration or necrosis was seen in 0 of 9 in group one and 5 of 6 in group two respectively, hemorrhage(0 of 9 and 5 of 6 respectively) and pseudocapsule(0 of 9 and 3 of 6 respectively. The difference between these findings in the two groups demonstrated statistical significance (P ＜ 0. 05). Conclusion The MR features of RAML containing miminal fat were hypointensity on T2 WI,angular interface with renal parenchyma and homogeneous contrast enhancement, however, these findings can vary depending on the tumor size.

Objective To investigate the value of magnetic resonance imaging(MRI)in the evaluation of microwave ablation(MA)for liver cancer.Methods The clinical data of 51 patients with liver cancer who received MA at the General Hospital of PLA from November 2005 to June 2009 were retrospectively analyzed.The MRI findings of 65 nodules before and after the treatment of MA were evaluated by serological examination and needle biopsy of liver.Results All patients received MRI within 1 month after MA.Of all nodules.63 were presented with high signal intensity on T_1-weighted images(T_1 WI)and low signal intensity on T_2-weighted images (T_2 WI)and with peripheral ring-like enhancement.They were diagnosed as complete coagulation necrosis,and the alpha-fetoprotein(AFP)level of the patients decreased from 333.83μg/L before MA to 37.68 μg/L after MA.Two nodules were presented with low signal intensity on T_1 WI and high signal intensity on T_2 WI,and they were diagnosed as local residual.All patients were followed up l month after MA,and 5 nodules showed enhancement with the same image characteristics as local residual.They were diagnosed as local recurrence of liver cancer by needle biopsy of liver and AFP level detection.New intrahepatic nodules in 23 patients and an abdominal nodule in 1 patient were detected with an increase of AFP level(mean,120.16 μg/L).Conclusion MRI Can exactly evaluate the efficacy of MA in the treatment of liver cancer.

AIM:To explore the feasibility of inducing mouse embryonic stem cells into neural stem cells in vitro. METHODS: Embryonic body induced by retinoic acid and retinal m?ller cells were selected in neural stem cell-defined medium for 7 days, and the morphological changes were observed. The selected cells were stained immunocytochemically with anti-nestin, anti-BrdU antibodies, and their ability of expansion and differentiation were analyzed. RESULTS:Large amounts of neurospheres were derived from embryonic body in the selected medium on the 7th day, which could be passaged and differentiated, stained positive with nestin and BrdU, and expressed nestin, glutaminase and Brn-3 genes. CONCLUSION:Neural stem cells could be derived from embryonic body induced by RA and m?ller cells in the selected medium, which would offer an alternative to treat neuropathy such as glaucoma and retinal degeneration in the future.

Objective To explore the CT and MRI manifestations and clinical features of juxtaglomerular cell tumor (JGCT). Methods A retrospective analysis the data of eight JGCT patients who resected by surgery and comfirmed by histopathology. Seven cases were examined by CT before operation, five of whom underwent CT scan and dynamic enhanced scan, two of whom underwent CT scan, and all of the eight underwent MRI scan and dynamic enhanced scan. The clinical manifestations of patients were also observed, whether they have hypertension and reduced blood potassium, recorded the results of lying and standing test, and collected the segmental renal vein blood to detect the renin levels. Meanwhile, the CT and MRI manifestations were also recorded. Results (1) We found that all of the eight patients appeared hypertension, and hypokalemia were found among five cases. Seven patients proceeded the lying and standing test, six of whom the plasma renin activity (PRA) were elevate in erect position, and the levels of angiotensin Ⅱand aldosterone (ALD) were rised among all of the seven cases in erect position. Four patients were collected the segmental renal vein blood, and one of whom has positive result of the renin activity. (2) The tumors of all the eight cases were single, the border was clear, and the average size was 2.7 cm (range 1.9 to 3.8 cm). The CT scan results showed there's no calcification or pseudocapsule were detected, four cases showed homogeneous iso-density, one case with slightly high density, another one showed low density with dotty high density and one case with low density. The dynamic enhanced CT scan showed that four cases performed continuous enhancement from cortical to medullary phase, and no obvious enhancement was found in one case. The T2WI results of MRI scan showed six cases had pseudocapsule, 6 cases had heterogeneous signal (4 cases with patchy low signal and 2 cases with patchy high signal), and 2 cases had homogeneous signal (one case with iso-high signal and another with high signal). The T1WI results showed two cases performed low signal, anther two cases showed iso-signal, and four cases with heterogeneous signal. The DWI results showed all of the 8 lesions with homo-or peripheral high signal. The dynamic enhanced MRI scan results showed seven cases performed gradual enhancement, and the border of another case became clear on delay phase. Conclusions JGCT has specific clinical and imaging features, and the combination will help make a correct diagnosis.

Objective To explore the value of ultra?high b?value DWI in diagnosis of prostate cancer in central gland. Methods Seventy?one consecutive patients, who were scheduled for prostate biopsy, were prospectively screened. T2WI, conventional DWI with b?value of 1 000 s/mm2 and ultra?high b?value DWI with b?value of 2 000 s/mm2 and 3 000 s/mm2 were performed in each examination. Twelve?core ultrasound guided prostate systematic biopsy was operated within 3 weeks after MRI examination. Images were interpreted based on prostate MR guidelines (PI?RADS) and were corresponding to histological results conducted by ultrasound guided prostate systematic biopsy. Using biopsy as the gold standard, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for different imaging methods. Sensitivity and specificity differences between ultra?high b?value DWI and conventional DWI were analyzed using the McNemar test. The areas under the curves (AUCs) between ultra?high b?value DWI and other modalities were compared by using the Z test. Results Forty lesions were identified in the prostate central glands from the 33 sample patients in 71 examinees. Twenty two lesions were identified as prostate cancer in 15 patients and 18 lesions were identified as benign prostatic hyperplasia in 18 patients. MRI analysis of lesions in central gland, 27 (67.5%), 20 (50.0%), 32 (80.0%) and 35 (87.5%) were diagnosed accurately with the T2WI, conventional DWI and ultra?high b?value DWI (b=2 000, 3 000 s/mm2) respectively. The sensitivity and specificity for ultra?high b?value DWI was 90.9%and 83.3% with a b?value of 3 000 s/mm2 and was 86.4% and 72.2% for 2 000 s/mm2. These values were significantly higher than conventional DWI with a b?value of 1 000 s/mm2 (59.1%and 38.9%, P<0.05). The detection of lesions was comparable with ultra?high b?value DWI at 2 000 s/mm2 and 3 000 s/mm2 (P>0.05). The AUCs were 0.674, 0.510, 0.793 and 0.871 in T2WI, conventional DWI and ultra?high b?value DWI at 2 000 s/mm2 and 3 000 s/mm2 respectively. ROC analysis showed greater AUCs for the ultra?high b value DWI, than for the T2WI and conventional DWI (P<0.05). Conclusion The ultra?high b?value DWI is a valuable MRI modality in the diagnosis of prostate cancer in central gland.

Objective To establish a method for detecting the concentration of paraquat (PQ) and creatinine(Cr) in urine simultaneously by capillary electrophoresis.Methods Experimental methodological study.8 acute PQ poisoned patients who were treated in the First People's Hospital of Lianyungang from January 2011 to June 2012 were collected.2 were male,and 6 were female.The separation were carried out using a 25 mmol/L pH1.97 glycine-HCl buffer(containing 40 mmol/L NaCl) in a fused-sillica capillary tube of 47 cm ×75μm I.D.by capillary zone electrophoresis.Urine had been injected by pressure for 4 s after samples were centrifuged and diluted for 10 times with H2O.The detection were monitored by a diode-array detector at 200 nm while samples were separated at a voltage of 20 kV.A systemic methodological evaluation of this method was carried out (The linear range,detection limit,repeatability test,recovery test and interference test).And the method was used to detect the concentration of PQ and Cr in PQ poisoned patients' urine.Results The peaks of PQ and Cr appeared within 5 min.The linear ranges of PQ and Cr were 2-1000,10-5000 μmol/L,respectively,with the correlation coefficients of 0.9997 and 0.9999 (P ＜0.01).The detection limits were 1.0 μmol/L for PQ and 5.0 μmol/L for Cr.The mean within-day(n =10) CVs of peak area for PQ and Cr were 2.84％ and 1.72％,while the mean inter-day(n =10) CVs of peak area were 3.62％ and 3.06％.The average recovery rate of PQ and Cr were 88.6％ and 90.2％ respectively.Diquat(DQ) didn't interfere with the assay.The range of PQ/Cr(μmol/mmol) for 8 cases was 8.9-2215.Conclusions A method was established successfully for the rapid determination of PQ and Cr in urine by capillary electrophoresis.The CE method devised here for direct measurement of urinary PQ and Cr from PQ poisoned patients is simple,fast,automatic and with good repeatability.It is an ideal method for rapid detection of urinary PQ in PQ poisoned patients.

Objective To explore the value of ultra-high b-value diffusion-weighted imaging(DWI) in diagnosis of prostate cancer. Methods According to inclusion and exclusion criteria, 73 consecutive examinees in Chinese PLA General Hospital from June 2014 to May 2015 were screened. Written informed consent was obtained from all patients. T2WI, conventional DWI with b-value of 1 000 s/mm2and ultra-high b-value DWI with 2 000 s/mm2and 3 000 s/mm2were performed in each examinee. Images were interpreted and were corresponding to histological results conducted by ultrasound guided prostate systematic biopsy. Reference biopsy as the gold standard,the sensitivity,specificity, positive predictive value(PPV) and negative predictive value (NPV) were calculated for each image. Sensitivity and specificity differences between ultra-high b-value DWI and conventional DWI were analyzed. The areas under the curves (AUCs) between ultra-high b-value DWI and other modalities were compared. Results The sensitivity and specificity for ultra-high b-value DWI were 92.5 % and 68.8 % with b-value of 3 000 s/mm2, and they were 88.1 % and 53.1 % for 2 000 s/mm2in peripheral zone. The sensitivity and specificity for ultra-high b-value DWI were 88.0 % and 88.2 % with a b-value of 3 000 s/mm2, and they were 80.0 % and 52.9 % for 2 000 s/mm2in transition zone. The values of sensitivity for ultra-high b-value DWI were significantly higher than those for conventional DWI both in peripheral zone and transition zone (all P <0.000 1). The detection of lesions was comparable with ultra-high b-value DWI at 2 000 s/mm2and 3 000 s/mm2in peripheral zone (P >0.05), whereas the value of specificity for 3 000 s/mm2were significantly higher than that for 2 000 s/mm2in transition zone (P<0.000 1). PPV and NPV for 3 000 s/mm2were significantly higher than those for the other three modalities both in peripheral zone(86.1 % and 81.5 %) and transition zone (91.7 % and 83.3 %). In peripheral zone, the AUCs were 0.591, 0.553, 0.698 and 0.806 in T2WI, conventional DWI and ultra-high b-value DWI at 2 000 s/mm2 and 3 000 s/mm2respectively, for the diagnosis of transition zone cancer were 0.693, 0.506, 0.665 and 0.881 respectively, and the AUCs for the ultra-high b-value with 3 000 s/mm2were the largest. Conclusion Ultra-high b-value DWI is an accurate and reliable method in the diagnosis of prostate cancer.

Objective To investigate the MRI features of renal oncocytoma(RO). Methods We retrospectively analyzed the data of 26 patients by histologically confirmed with RO in Chinese PLA General Hospital from September 2006 to May 2017 and performed pre-operative MRI and dynamic contrast-enhanced MRI.Lesions were divided into two groups based on the diameter:large group with large than 3 cm(16 cases,16 lesions)and small group with less than 3 cm(10 cases,11 lesions).Features of each lesion were analyzed, including location, pseudocapsules, lipids and other 11 indicators. Tumor imaging features were compared between two groups by univariate and multivariate logistic regression analysis. Results Of 27 RO lesions, 12 were located in the left kidney and 15 in the right kidney. Twenty five lesions appeared exophytic(92.6%,25/27),10 lesions showed exophytic angular interface(37.0%,10/27), 25 lesions showed pseudocapsule(92.6%,25/27),4 lesions appeared lipid(14.8%,4/27),2 lesions showed cystic degeneration or necrosis(7.4%,2/27),1 lesion showed hemorrhage(3.7%,1/27),13 lesions appeared fibrous scar(48.1%,13/27),19 lesions with moderate or intense enhancement in the corticomedullary phase (70.4%, 19/27), 9 lesions with wheel-spoke-like enhancement (33.3%, 9/27), and 2 lesions showed segmental enhancement inversion (7.4%, 2/27). Univariate logistic regression exhibited statistically significant correlation between exophytic angular interface with renal parenchyma,fibrous scar,moderate or intense enhancement in the corticomedullary phase,and wheel-spoke-like enhancement of the tumors both in small and large RO groups with OR value of 0.054, 9.898, 8.400 and 10.000, respectively. In the multivariate logistic regression analysis, exophytic angular interface with renal parenchyma and intense enhancement in the corticomedullary phase were found to be high risk factors with OR value of 0.033 and 15.381,respectively.Conclusions The main manifestation of RO on MRI is that both kidneys can occur, with many exogenesis, pseudocapsules, but less lipids, cystic degeneration, necrosis, hemorrhage and segmental enhanced reversal;smaller lesions(diameter<3 cm)tend to conical interface,while larger lesions (diameter≥3 cm)may have fibrous scars,spoke-shaped enhancement,moderate and significantly enhanced cortical phase characteristics.