Objective:To observe and analysis the clinical presentations and high resolution computed tomography (HRCT) features of patients with eosinophilic granulomatosis with polyangiitis (EGPA), and to provide support for clinical diagnosis and treatment decision.Methods:Clinical characteristics, relevant laboratory data, HRCT features, treatment and prognosis of 15 clinically confirmed EGPA patients were analyzed retrospectively. Statistical Program for Social Sciences (SPSS) 21.0 software was used for statistical analysis of the data.Results:Among the 15 patients, there were 8 males and 7 females, with a midian age of 48. Four cases (27%) were misdiagnosed as refractory asthma for the first time. The most common clinical manifestation was paranasal sinus inflammation in 14 cases (93%), followed by cough and wheeze in 13 cases (87%). In the laboratory examination, eosinophilia was found in 13 cases (87%) and ANCA positive in 5 cases (39%). The common chest HRCT signs were: fiber stripes in 13 cases (87%), patch ground glass opacities in 12 cases (80%), interlobular septal thickening in 10 cases (67%), and nodules in 9 cases (60%). The five-factor score (FFS) was used to score the patients, and FFS were 5(33%) with score 0 and 6(40%) with score1. Finally, 12 patients (80%) were discharged after remission.Conclusion:The EGPA has a low incidence and no spefic clinical manifestations and chest HRCT features, so it hasto be diagnosed by combination of paranasal sinus examination, electromyography and laboratory tests.

OBJECTIVE:To provide reference for the identification,processing,processing technology and research for ther-mal decomposition products. METHODS:Thermogravimetry- derivative thermogravimetry (TG-DTG) and differential thermal-de-rivative differential thermal (DTA-DDTA) analysis were conducted to scan thermal spectrum of tripterygium from 3 places and T. hypoglaucum,T. regelii,common counterfeits Actinidia arguta and Vitis quinquangularis,determine 7 medicinal materials,its dregs and extractum,and analyze differential spectrum of T. wilfordii and dregs. RESULTS:The TG-DTG and DTA-DDTA thermal spectrum were not only basically similar to each other but also to their dregs. There was a singlet main characteristics peak at about (299±3)℃ only in the DTG curves of extracts of tripterygium from 3 places and T. hypoglaucum extractum with similar intensity, while T. regelii,counterfeits A. arguta and V. quinquangularis showed multiple peaks,and (299 ± 3)℃ was not the main peak. CONCLUSIONS:The thermal spectrum can not distinguish tripterygium and its counterfeits;extractum DTG curves can do it;suit-able processing temperature of tripterygium was 200-380℃. The study can provide reference for the identification,processing,pro-cessing technology and research for thermal decomposition products.

Right-sided cardiac valvular diseases have traditionally been considered less important than disease of mitral or aortic valve. However, severe tricuspid regurgitation could lead to right ventricle dysfunction and reduce patients' survival rate. In clinic setting, tricuspid valve disease should be paid more attention for patients with secondary tricuspid regurgitation caused by left-sided valvular surgery combined with irreversible annular dilatation increasing the risk of reoperation. In this review, we summarize the epidemiology, anatomy, pathology, diagnosis, ultrasound and cardiac magnetic resonance imaging findings in patients with tricuspid regurgitation.
Echocardiography ; Heart ; Heart Valve Diseases ; diagnosis ; Heart Ventricles ; diagnostic imaging ; pathology ; Humans ; Magnetic Resonance Imaging

Objective To investigate the prevalence of morphological abnormalities of the internal carotid artery and relationship with ischemic cerebrovascular disease and carotid atherosclerosis.Methods A total of 511 consecutive patients were enrolled in this study and carotid abnormalities were classified according to the criteria of Wain and Metz by combining high-and low-frequency ultraaonography prospectively.Relationship of carotid abnormalities to ischemic cerebrovascular disease and carotid atherosclerosis were analyzed.Results Of the 511 cases,abnormalities of the internal carotid artery were found in 256(50.1 ％),the unilateral carotid abnormalities were found in 121(23.7％),and the bilateral in 135(26.4％),respectively.There was significantly difference in prevalence of kinking and coiling between ischemic stroke and asymptomatic group(P＜0.001),and prevalence of carotid abnormalities in the plaques and arteriosclerosis groups were statistically higher than the normal group(P＜0.001).Conclusions The kinking and coiling of the internal carotid artery could be additive risk factors in the pathophysiology of an ischemic stroke,and carotid morphological abnormalities could be responsible for carotid atherosclerosis partly.

Objective To evaluate the imaging features of ulcer-like projections (ULP)and penetrating atherosclerotic ulcers (PAU)of intramural hematoma(IMH)using dual-source CT (DSCT).Methods Retrospectively analysis of DSCT imaging data of 1 12 patients in our hospital was performed.The shape of hematoma and location of ULP and PAU were evaluated Stanford A and B IMH depicting on DSCT images.The maximum diameter of aorta,maximum thickness of hematoma,deepness of ulcer were com-pared between in patients of IMH with or without ULP and PAU.Results IMH manifested as circular or crescent high density on plain scan and without contrast enhancement on DSCT images in 1 12 cases.Among of them,68 cases(68/1 12,61%)of IMH had ULP or PAU,in which there were 21 cases(21/1 12,1 9%)with ULP and 47 cases(47/1 12,42%)with PAU,the mean maximum depth was (0.48±0.1 5)cm in ULP and (1.08±0.56)cm in PAU.There were 4 cases with ULP and 9 cases with PAU in 29 cases of Stanford type A,while 1 7 cases with ULP and 38 cases with PAU in 83 cases of Stanford type B.There were 14 cases with single ULP and 7 cases with multiple ULP in 21 patients with ULP,while there were 27 cases with single PAU and 20 cases with multiple PAU in 47 patients with PAU.There were 1 9 cases with both PAU and ULP.There was statistical significance that PAU occurred more likely in the descending aorta and distal aorta than that in ULP (P =0.028).Conclusion IMH patients are susceptible to ULP and PAU,DSCT can objectively evaluate CT features of ULP and PAU of IMH.

Objective To investigate the multi-slice spiral computed tomography (MSCT) features of crush maxillofacial frac-tures in the massive Wenchuan earthquake. Methods MSCT data of 85 patients with crush maxillofacial fractures caused by earth-quake were retrospectively analyzed. The anatomic distribution of fractures was evaluated. Results In 85 patients, single bone frac-tures (59 patients) were more common than multiple bone fractures (26 patients) (P<0.05). The fractures involved isolated mid-face, isolated mandible, and both were found in 49 patients (57.6%), 24(28.2%), and 12(14.2%), respectively. Midface frac-tures were most frequent (P<0.05). The fractures of condyle, posterolateral and anterior wall of maxillary sinus, zygomatic arch and lateral orbital wall accounted for 47.1%(24/51) ,41.5%(22/53) , 37.7%(20/53),71.9% (23/32) and 63.2%(24/38) of the total fractures of the corresponding maxillofacial bones. Conclusion Isolated bone fracture and midface factures are the main fea-tures of crush maxillofacial fractures resulted from the massive earthquake. MSCT and three-dimensional reconstruction images can demonstrate maxillofacial fractures well.

Objective To determine how the pulmonary ligament affects the helical CT appearances of the lower thoracic disease on the basis of the anatomic findings. Methods Four cadavers were cut transversely, with the section thickness of 11.3-13.4 mm. 57 patients with the lower thoracic disease were scanned using Somatom Plus 4, with administration of intravenous contrast material. The correlation of the anatomic findings of the pulmonary ligament and the helical CT appearances of the lower thoracic disease was evaluated. Results On cadaver sections, the right pulmonary ligament attached the lower lobe of the right lung to the esophagus, while the left ligament attached the lower lobe of the left lung to the esophagus or the descending aorta. In 40 pleural effusion and 7 pneumothorax cases, the pulmonary ligament tethered the medial aspect of the collapsed lower lobe and limited the shift of the lower lobe. In 40 pleural effusions, the ligament divided the medial pleural space into an anterior and a posterior compartment. The ligament showed thickness due to the invasion of the lesions of lower lobe including 7 tumors and 3 inflammatory diseases. Conclusion The pulmonary ligament can affect the helical CT appearances of the lower thoracic disease, such as lobe collapse, pleural effusion and pneumothorax; while the intraparenchymal and mediastinal abnormality can extend into the pulmonary ligament.

Objective To investigate the effect of cobalt chloride on tumor cell proliferation and apoptosis in vitro, to explore the reasonable strategy of chemical hypoxia induced by CoCl2. Methods Two tumor cell lines (A549 and HeLa) were respectively exposed to CoCl2(0.05～2 mmol/L) for different time period (4～48 h), cells viability、proliferation and apoptosis were maesured by MTT and FCM methods. HIF-1? and related apoptosis proteins expression were detected by Western blot. Results Cells viability was weakly changed in low concentration(≤200 ?mol/L)of CoCl2 within 24 h. However, higher dose or prolonged challenge of CoCl2 significantly decreased cell survival rate (P

We studied the actions of diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) in differentiating breast tumors. From January 2010 to February 2012, we retrospectively analyzed data of 95 cases with breast tumor pathologically confirmed from DWI and DCE-MRI. We compared the ADC value, time-intensity curve (TIC) and DCE-MRI parameters between breast tumors, and calculated the sensitivity and specificity for differentiating breast tumors. The results were as follows: (1) On DWI, mean ADC value of malignant tumor was lower than that of benign tumor (P < 0.05). For differentiating breast malignant tumors from benign neoplasm, a cut-off ADC value of 1.2 x 10(-3) mm2/s achieved a sensitivity of 74.1% and specificity of 70.3%. (2) On DCE-MRI, early enhancement ratio (EER) value of malignant tumor was higher than that of benign tumor whereas value of time to peak (Tpeak) and maximal enhancement ratio (SImax) were lower than that of benign tumor (all P < 0.05). As for TIC, type II and III were more frequently seen in malignant tumor than in benign tumor whereas type I was more common in benign tumor than in malignant tumor (all P < 0.05). For differentiating breast malignant tumors from benign neoplasm, DCE-MRI obtained a sensitivity of 89.7% and specificity of 70.3%. (3) For differentiating breast malignant tumors from benign neoplasm, ADC value together with TIC obtained a sensitivity of 79.3% and specificity of 78.4%. Malignant or benign breast tumors could have their own unique characteristics on DWI and DCE-MRI. These characteristics might be helpful for differentiating these tumors.
Breast Neoplasms ; classification ; diagnosis ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Sensitivity and Specificity

This study aims to explore the inferior adhesion of the renal fascia (RF), and the inferior connectivity of the perirenal spaces (PS) with multidetector computed tomography (MDCT), and to investigate the diagnostic value of CT for showing this anatomy. From May to July 2012, eighty-two patients with acute pancreatitis presented in our hospital were enrolled into this study and underwent contrast-enhanced CT scans. All the image data were used to perform three dimensional reconstruction to show the inferior attachment of RF and the inferior connectivity of PS. The fusion of anterior renal fascia (ARF) and posterior renal fascia (PRF) next to the plane of iliac fossa were found on the left in 71.95% (59/82) cases, and on the right in 75.61% (62/82). In these cases, bilateral perirenal spaces, and anterior and posterior pararenal spaces were not found to be connected with each other. No fusion of ARF and PRF below the level of bilateral kidneys occurred on the left side in 28.05% (23/82) cases and on the right side in 24.39% (20/82). In these patients, the PS extended to the extraperitoneal space of the pelvic cavity and further to the inguinal region, and bilateral anterior and posterior pararenal spaces were not found to be connected with each other. Three-dimensional reconstruction on contrast-enhanced MDCT could be a valuable procedure for depicting inferior attachment of RF, and the inferior connectivity of PS.
Abdominal Cavity ; anatomy & histology ; Adult ; Contrast Media ; Fascia ; anatomy & histology ; Humans ; Image Processing, Computer-Assisted ; Kidney ; anatomy & histology ; Multidetector Computed Tomography ; Pancreatitis ; pathology ; Pelvis ; anatomy & histology ; Tomography, X-Ray Computed