Aerenchyrna formation has been described in depth in a number of species at a histological level. But large gaps remain in our understanding of its regulation as a developmental process. It is attempted to analyse essential mineral elements like K, Mg, Cu, Zn, Ca and P in the cell wall of aerenchyma cells in petioles ofS. trifolia at five different developmental stages by CSEM-EDX technique. At early stage, K and Cl concentrations in cell wall were high up to 36% and 4.3% of dry weight, respectively. It supported the hypotheses that aerenchyma spaces are filled with liquid at early developmental stages of aerenchyma in S. trifolia petiole. Mg concentration was high at stage 2, up to 0.86% of dry weight. Zinc and Cu were detected only at rapid expansion stages, during which the concentrations were up to 1.5% and 2.5%, respectively. Calcium was detected in the cell wall only at mature stages, the concentration was high up to 1.3% of dry weight at stages 4 and 5. These results confirmed that the element concentration of aerenehyma cell wall undergoes dynamic changes during different developmental stages, and a low Ca with high Zn and Cu concentration are needed for cell expansion. Copper and Zn deposition in the cell wall showed a significant positive linear correlation, suggesting that these two elements share same or similar uptake and transport mechanism in plants.

Objective To investigate the diagnostic value of MSCT with multi-planar reconstruction(MPR)and maximum intensity projection(MIP)in diagnosis of spinal burst fracture.Methods 45 patients(53 vertebras)with vertebral burst fracture were examined by MSCT and processed with MPR and MIP.The imaging features were analyzed comparatively.Results The axial images clearly demonstrated the vertebral body vertically or transversely burst crack in 49 vertebras(92.5%),bony fragment inserted into the spinal canal and stenosis of spinal canal in 34 vertebras(64.2%).The sagittal images showed kyphosis in 28 vertebras(62.2%).The sagittal and coronal images showed decreased height of the vertebral body in 37 vertebras(69.8%)and depressed fracture of vertebral end plate in 19 vertebras(35.8%).Total 44 fractures were located at spinal appendix,39 were showed by axial images,35 by sagittal images and 33 by coronal images.MIP displayed the space changes of bone structures in all cases and rotary dislocation fracture in 6 cases(11.3%).Conclusion MPR and MIP are of significant values in diagnosis and clinical treatment of spinal burst fracture.

Objective To investigate the expression of sodium iodide symporter (NIS ) mRNA in differentiated thyroid Carcinoma (DTC)and further explore its value in clinical diagnosis and therapy of DTC. Methods The expression of NIS mRNA was detected and analyzed in 21 nodular goiter and 45 cases of DTC (including 35 cases of papillary thyroid carcinoma and 10 cases of follicular thyroid carcinoma)by using real-time fluorescent quantitative reverse transcription polymerase chain reaction (real-time RT-PCR).Results Compared with that in nodular goiter,the mRNA expression of NIS in DTC tissue was significantly decreased (P < 0.05 ). Moreover,the mRNA expression of NIS was significantly correlated with lymph node metastasis and AJCC stage, respectively.The expression of NIS mRNA in DTC with lymph node metastasis was significantly decreased compared with that in DTC without lymph node metastasis (P <0.05).In addition,the expression of NIS mRNA in Ⅱ-Ⅳstage DTC was significantly decreased compared with that in Ⅰ - Ⅱ stage DTC (P < 0.05 ).Conclusion Differential expression of NIS can provide evidence for individual 1 3 1 I therapy for DTC.

Objective To analyze the mammographic findings of ductal carcinoma in situ,and to improve DCIS diagnosis.Methods 1 58 cases of infiltrating ductal carcinomas,27 cases of DCIS and 14 cases of DCIS with microinvasion identified by postoperative pathological were collected,and their mammographic data were analyzed etrospectively.Results There were significantly more calci-fication and pure calcification in DCIS group than in IDC group(both P <0.05 ).And have no statistically significant difference be-tween those two diseases for the shap of calcification(P >0.05),both of them mostly showed granula and punctate calcification.There were statistically significant difference those two diseases for the distribution of calcification (P <0.05),the linearity and V-shaped segmental distribution occupies a relatively high percentage in DCIS while the cluster-like calcification occupies a relatively high percentage in IDC.Conclusion Pure calcification is mainly mammographic feature of DCIS.The characteristic of calcification is distribute along duct.

Objective To learn the various clinic characteristics of newly T tuberculosis (TB) patients ,investigating the preven-tion and treatment knowledge of TB patients ,in an effort to provide scientific evidence for targeted prevention and control meas-ures .Methods Retrospectively analyzing the common demographic characteristics of 648 newly and 434 old TB patients from Sep-tember 2011 to September 2012 ,diagnostic information ,the awareness on the prevention and treantment ,drug use situation and so on .Results Among these patients ,most of them were males(60 .2% ) ,the middle age and the young were the majority (77 .8% ) , the disease areas were mainly rural ones (61 .6% ) ,and manual workers (65 .4% ) ,secondary pulmonary TB was in the majority (72 .8% ) ,40 .0% (52/130) of the patients with TB pleuritis were accompanied by pulmonary TB .TB patients usually combined with pneumonoconiosis(8 .0% ) ,diabetes(3 .6% ) ,asthma(4 .3% ) and some other fundamental diseases .The old TB patients had more prevention and treatment knowledge about TB than those newly patients (P<0 .05) .The major source of newly patients about the knowledge were mainly from their relatives and friends (30 .3% ) ,whereas the old patients from teaching of medical care (36 .9% ) .The main reasons for irregular usage of medicine came from the lack of knowledge about the course period of treatment (45 .3% ) ,and the disappearing of TB symptoms (30 .8% ) .Conclusion In the less developed rural areas ,the young and middle aged males who mainly done physical work were the majority patients .These newly patients have little prevention and treatment knowledge about TB .Comprehensive hospitals played an important role in transmission of TB knowledge .In the process of educa-tion ,we should pay special attention on the following less known but essential points :mode of transmission ,protective measures , course period of treatment ,monitoring side effect ,giving out free medicine ,and the prognosis of TB .

Objective To study the CT features of peripheral lung cancer with thin-walled cavity, and to improve the understanding and diagnostic accuracy of this type of lung cancer. Methods Thirty-one patients (male:18, female:13, average age(56 ± 12)years old) with surgically proven peripheral lung cancer with thin-walled cavity were studied retrospectively. There were 28 cases of adenocarcinoma, 2 cases of squamous cell carcinoma and 1 case of sarcomatoid carcinoma. All patients had MSCT examination, and the CT features of the solid lesion and thin-walled cavity of the lung cancer were analyzed. The relationship between solid lesion and thin-walled cavity location, cavity wall thickness and uniformity, wall nodules, vascularstructures close to the outer wall, septum or air-fluid level inside the cavity, and dynamic changes of the lesions were all evaluated. Results (1) Solid lesion:mostly located in both upper and middle lobes of the lung in 21cases (67.7%). Lobulation, speculation and vessel convergence sign were observed in 27 cases (87.1%), 21 cases(67.7% )and 16 cases(51.6%) respectively. Twenty cases showed as ground glass nodule (GGN) (64.5%), with pure GGN in 11 cases(35.5%). (2) Cavitary lesion: The average diameter was (2.7 ± 1.3) cm, the cavity located in the periphery of the solid lesions in 26 cases (83.9%),and in 20 cases (64.5%) located in the lateral or superior and inferior lateral aspect of the solid lesion;The cavity wall was uniform in17 cases (54.8%) and the wall thickness<2 mm were seen in 16 cases (51.6%), 2-3 mm were observed in 10 cases (32.3%);Wall nodules were seen in five cases (16.1%);Blood vessels adjacent to outer wall were found in 12 cases (38.7%);There was no air-fluid level in the cavity in all the cases;But septum with uneven thickness or small vessels were seen in the cavity in 27 cases (87.1%). Conclusions The majority of peripheral lung cancer with thin-walled cavity was adenocarcinoma, characteristic CT features of thin-walled cavitary lesions may be helpful in the diagnosis of this type of lung cancer.

Objective To evaluate the efficacy and safety of sunitinib as post-operative adjuvant therapy in patients with high-risk renal cell carcinoma (RCC).Methods A total of 60 patients with resected,histologically confirmed clear cell RCC were enrolled in this study.Patients received orally sunitinib either at a dose of 50 mg on treatment schedule (once daily for 4 weeks followed by 2 weeks off) or at a dose of 37.5 mg once daily for three 6-week cycles from 1 month after surgery.Results All the 60 patients tolerated Sunitinib treatment well and no patient discontinued treatment due to adverse events.Most adverse events were grade Ⅰ to Ⅱ.The most frequently reported adverse events were neutropenia (56.7％),thrombocytopenia (53.3％),leucopenia (48.3％),hand-foot syndrome (46.7％) and hypertension (36.7％).The most frequently reported grade 3 or 4 toxicities were thrombocytopenia (25.0％),neutropenia (15.0％),hand-foot syndrome (11.7％) and leucopenia (8.3％).The majority of adverse events occurred within the first 1-2 cycles of sunitinib treatment,and was ameliorated 1 month after 3 cycles finished.No irreversible adverse event was observed.As of April 5,2012,no recurrence occurred in patients except one death due to cerebrovascular accident unrelated to treatment,with both 6-month and 9-month disease-free survival rate of 100％.Conclusions Myelosuppression occurred less frequently in high-risk RCC patients treated with sunitinib as operative adjuvant therapy than in advanced RCC patients,with a better benefit trend.However,long-term follow-up data are needed to further confirm the efficacy of sunitinib in the adjuvant setting.

OBJECTIVE To analyze the new features in diagnosis and treatment of parathyroid tumor co-existent with thyroid disease. METHODS The clinical data of 98 patients with parathyroid tumors from Jan.2007 to Dec.2016, in Zhejiang Cancer Hospital were retrospective analyzed. RESULTS In all 98 cases, there were 22 cases mistaken as thyroid disease before surgery. The misdiagnosis rate was higher(36.2％), when combined with thyroid disease. When co-existent with thyroid disease, the qualitative diagnosis rate of the ultrasound and CT will be decreased, it was easy to misdiagnosis. Logistic regression analysis showed that parathyroid tumor location, hyperparathyroidism, cystic parathyroid tumor affected the accuracy of the qualitative diagnosis of ultrasound. The size of the parathyroid tumor affected the accuracy of the qualitative diagnosis of CT. Three of 9 patients underwent bilateral thyroid cancer and parathyroid tumor resection presented permanent hypoparathyroidism(33％). CONCLUSION When combined with thyroid disease, parathyroid tumor is easy to be misdiagnosed, the qualitative diagnosis rate of the ultrasound and CT will also decreased. When combined with thyroid cancer, these will be a higher risk of hypoparathyroidism after bilateral thyroid cancer and parathyroid tumor resection.

Background and purpose: Regional lymph node metastasis was significantly associated with the prognosis of patients with non-small cell lung cancer (NSCLC). This study was designed to compare paclitaxel liposome plus cisplatin (LP) with gemcitabine and cisplatin (GP) in patients with regional lymph node metastasis of advanced NSCLC as a ifrst-line treatment. Methods:A total of 55 patients were randomly assigned to receive either liposomal paclitaxel (175 mg/m2) and cisplatin (75 mg/m2) or gemcitabine (1 000 mg/m2) and cisplatin (75 mg/m2) every 3 weeks. Results:Objective response rate (ORR) of lung primary foci was 37.9%in the LP arm and 30.8%in the GP arm (P>0.05) and the disease control rate (DCR) was 91.3%and 80.8%respectively (P>0.05);ORR of regional metastasis lymph node was higher in the LP arm (44.8%vs 15.4%, P<0.05).There was no signiifcant difference in DCR (93.1%vs 73.1%, P=0.101), although slight trends favoring paclitaxel liposome were seen;There was signiifcant difference in median overall survival (17.0 vs 12.0 months, P<0.05). LP was associated with significantly less thrombocytopenia and gastrointestinal side effects (P<0.05), but no signiifcant difference was observed in hyphemia, leucopenia, hepatotoxicity, renal toxicity and allergic reactions (P>0.05). Conclusion: Liposomal paclitaxel plus cisplatin is superior to gemcitabine plus cisplatin with less toxicity and better tolerated, it deserves further research and clinic application for patients with regional lymph node metastasis of advanced NSCLC.

Objective To explore the clinical significance of integrated screening of RET in a Chinese multiple endocrine neoplasia type 2A(MEN 2A)family and to evaluate the feasibility and effectiveness of prophy-lactic total thyroidectomy to MEN 2A-related medullary thyroid carcinoma ( MTC).Methods Medical history was obtained from 10 family members in a 3-generation south China family .Systemic investigations including bio-chemical tests, imaging examinations and germline RET screening were performed .3 asymptomatic mutation car-riers underwent prophylactic total thyroidectomy .Results RET screening showed a heterozygous missense muta-tion of TGC to CGC at codon 634 on exon 11 in 6 members(p.C634R), which was completely consistent with the clinical manifestations.There were 4 males and 2 females.The initial mean diagnostic age of 33.5 years(ranging from 19 years to 65 years) and the mean maximum diameter of MTC was 2.3 cm(ranging from 0.7 cm to 5.2 cm). Among them 3 members had palpable neck masses (1 case with diarrhea).Right total thyroidectomy +right level Ⅵlymph-node dissection with modified right neck dissection in one case , and bilateral total thyroidectomy +bilat-eral level Ⅵlymph-node dissection in 2 were performed .In other 3 asymptomatic mutation carriers , prophylactic total thyroidectomy +bilateral level Ⅵ lymph-node dissection were also performed .Among them, 1 case of a-symptomatic pheochromocytom ( PHEO) underwent cortical-sparing adrenalectomy before MTC .After the first op-eration, 4 patients still presented a high value of calcitonin , among whom 1 patient( T3N 1bM 0-1) underwent re-operation for 3 times after the initial operation and presented metastasis to bone after 130 months, taking vandet-anib orally up to now;2 patients underwent reoperation at 6 and 7 months after initial operation respectively (T1N 1bM0 and T2N 1bM0), and the other one patient was closely monitored and followed up for 22 months(T2N 1b M0).Moreover, The calcitonin levels dropped to normal in the other 2 asymptomatic cases(T1N0M0) who were followed up for 20 months.Conclusions Pedigree screening can work up an early diagnosis and improve the prognosis of MEN 2A.Integrated screening of RET and pre-operative calcitonin level measurement and prophylac-tic thyroidectomy for asymptomatic RET mutation carriers are reasonable and effective .