ObjectiveTo analyze the CT appearances of primary pulmonary non-Hodgkin lymphoma(PPNHL)in order to improve its diagnosis.MethodsCT manifestations of 19 cases with PPNHL confirmed by pathology and clinical follow-up were retrospectively analyzed.ResuitsNodules 7 cases and masses 8 cases in PPNHL were ill-defined and markedly enhanced,in which air bronchogram was commonly seen.Muhiple patchy areas distributed in the bilateral lungs were found in 9 cases.Consolidation 7 cases was lobar and markedly enhanced,in which air bronchogram was commonly seen.Interstitial change manifested as bilateral diffuse ground-glass opacities and reticular shadow was found in 1 case.Mixed imaging manifestations were detected in 10 cases.Pleural effusion 4 cases was uncommon.Conclusion CT manifestations of PPNHL are varied,but some specific imaging features still exist,CT examination combined with clinical manifestations is helpful for the diagnosis of PPNHL.

Congresses as Topic ; Head ; surgery ; Neck ; surgery ; Otolaryngology

Objective To investigate the CT features of pulmonary sarcoidosis.Methods Ninety patients with histologically proved pulmonary sarcoidosis were retrospectively studied by using CT scans and clinical recording.Results The main CT findings of pulmonary sarcoidosis were nodules which were seen in 69 cases(76.7%),and the nodules mostly distributed around the bronchovascular bundle(n=37, 41.1%).Other abnormalities included consolidation(n=31,34.4%),ground-grass(n=39,43.3 %), thickening of bronchovascular bundle(n=30,33.3%),interlobular septal lines(n=58,64.4%), fibrosis(n=17,18.9%)including bronchial distortion(n=8,8.9%),linear shadow(n=5,5.6%), and honeycombing shadow(n=4,4.4%),air-trapping(n=3,5.3%),bronchial straitness(n=8, 8.9%),pleural thickening(n=42,46.7%),and hilar and mediastinal adenopathy(n=76,84.4%). Two or more abnormal findings co-existed in 83 cases.The pulmonary lesions co-existed with hilar and mediastinal adenopathy in 76 cases.The nodules(n=25),consolidation(n=9),ground-grass(n=11), thickening of bronehovascular bundle(n=10)were improved after therapy.Ten cases of the interlobular septal(10/22),0 of bronchial distortion(0/4),1 case of diffuse linear(1/3),and 0 case of honeycombing(0/2)were improved.Conclusion CT manifestations of pulmonary sarcoidosis are varied, but has some specific radiographic features.A correct diagnosis can be made.combined with hilar and mediastinal adenopathy.

Objective To compare the different effects of 1% diatrizoate meglumine,2.5% mannitol and water as oral contrasts in PET/CT scan in gastrointestinal tract delineation and 18F-fluorodeoxyglucose (FDG) uptake. Methods Sixty-one patients referred for PET/CT scan without gastrointestinal diseases were divided into three groups randomly ( random number method). One liter of 1% diatrizoate meglumine,2.5% mannitol,or water was orally taken by groups 1 (25 cases),2 (20 cases) and 3 ( 16 cases),respectively before scan. The scan was performed with GE Discovery LS PET/CT scanner in two-dimensional (2D) mode 50 min after 18F-FDG (5.55 MBq/kg) injection. Patients with abdominal lesions were excluded from this study. The degree of gastrointestinal filling and 18F-FDG uptake was evaluated by 3 nuclear medicine physicians using visual analysis according to a 4-grade classification method:none,mild,moderate,and high. Statistically analysis was performed by Kruskal-Wallis,Mann-Whitney and paired t tests.Results Both the differences of serum glucose and insulin levels were not significant before and after contrast taken in group 2. Group 2 had better gastrointestinal filling than that of group 1 and also better than group 3 except in rectum. The stomach,jejunum,ascending,and transverse colon were better filled in group 1 than in group 3. The degree of 18F-FDG uptake of group 3 was significantly higher than that of group 2 in stomach,jejunum and ileum (z= -3. 192,-3.290,-3.290,all P＜0.05),and was also significantly higher than that of group 1 (z = - 3. 603,P ＜ 0.05) in jejunum. The degree of 18 F-FDG uptake of group 3 was significantly lower than that of group 1 in ascending colon (z = - 2. 706,P ＜ 0. 05 ) and was significantly lower than that of group 1 and 2 in transverse and descending colon (z= - 3. 503,- 2.403,- 4.225,-4. 027,all P ＜0.05),and was also significantly lower than that of group 2 in rectum (z = -4. 128,P ＜0. 01 ). The maximum CT values in stomach,jejunum,ileum and ascending colon in group 1 were ( 132 ±23),(191 ±31),(313 ±47) and (374±53) HU,respectively,whose difference was significant (t = -7.088--1.781,all P ＜0. 01 ). Conclusion Oral iso-osmotic mannitol intake has better gastrointestinal filling and less physiological 18F-FDG uptake compared to diatrizoate meglumine and water.

Objective:To observe the expression of the tumor suppressor gene (P53),apoptosis signal receptor (Fas),tumor necrosis factor alpha ( TNF-α) and Cyclin E ( Cyclin E) in serum and cancer tissues with papillary thyroid cancer patients ,and explore their relationship with the clinical pathology characteristics of thyroid papillary carcinoma .Methods:The puncture diagnosis in patients with papillary thyroid carcinoma as the experimental group (n=74),physical examination of healthy people as the normal control group (n=26).The two groups were fasting venous blood samples ,the experimental group in postoperative specimens from cancer tissue , adjacent normal tissue and 7 days after the fasting venous blood was sampled again.Protein content of P53,Fas,TNF-αand Cyclin E was detected by ELISA in serum , cancer adjacent normal tissue and cancer tissue;using real-time fluorescent quantitative assay to observe the gene expression of P53,Fas,TNF-αand Cyclin E in thyroid papillary carcinoma and adjacent normal tissues ; protein expression by immunohistochemical methods in papillary thyroid carcinoma and adjacent normal tissues P 53,Fas,TNF-αand Cyclin E analysis;the clinical expression with papillary thyroid cancer staging , pathological Type and has no relationship to lymph node metastasis.Results:The protein concentration in serum of patients with papillary thyroid carcinoma P 53 , Fas and TNF-αwere significantly lower than that of the normal control group ,Cyclin E protein content was significantly higher than that of normal control group ,the differences were statistically significant (P<0.01);thyroid papillary carcinoma P53,Fas and TNF-αprotein content,protein expression strength and gene expression levels were significantly lower than the normal tissues adjacent to cancer ,protein content ,Cyclin E protein expression and gene expression intensity was significantly higher than that in normal tissues ,the difference was statistically significant (P<0.05).Conclusion:The expression of p53,Fas and TNF-αin papillary thyroid carcinoma lower and expression level of Cyclin E increase ,may play an important role in papillary thyroid cancer invasion and metastasis.Combined detection of the four can be used as markers for early diagnosis of papillary thyroid cancer ,enhance the rate of early diagnosis of thyroid papillary carcinoma.

Objective To investigate the clinical outcomes derived from Ningmitai combined with tamsulosin to prevent double-J stent syndrome after laser lithotripsy with ureteroscope. Methods 117 patients underwent laser lithotripsy with ureteroscope and then placed a double-J stent for draining were collected from January 2010 to January 2013. Patients with double-J stent placement were divided into four groups determined by dosage regimen. Tamsulosin group (30 cases) was treated with tamsulosin (0.4 mg once daily) lonely, Ningmitai group (29 cases) was treated with Ningmitai (1.52 g, trice time a day) lonely, tamsulosin combined Ningmitai group (30 cases) was treated with tamsulosin and Ningmitai at the same time, operation control group (28 cases) was neither tamsulosin nor Ningmitai. The catheter was removed on the 3rd day post-lithotripsy and then remained double-J stent for 1 month. The scores of urinary tract, pain and the incidence of gross hematuria were assessed. Results The significant differences in the improvement of symptom score (χ2=22.038, P=0.000), pain score (χ2=9.876, P=0.020) and hematuria (χ2=8.000, P=0.046) were found among tamsulosin group, Ningmitai group, and tamsulosin combined Ningmitai group. The number of patients with symptomless, slight symptom in tamsulosin combined Ningmitai group were higher than those of tamsulosin group, Ningmitai group, operation control group (symptomeless:14 vs. 6, 3 and 2 cases;slight symptom:13 vs. 9, 5, 4 cases). The number of patients with>Ⅱpain score (7 vs. 9, 14, 17 cases) and incidence of hematuriag [26.6%(8/30) vs. 56.7%(17/30), 58.6% (17/29), 53.6% (15/28)] were lower in tamsulosin combined Ningmitai group than those of tamsulosin group, Ningmitai group, operation control group. The drug combination of Ningmitai with tamsulosin had the synergism to relived symptom and pain, and showed the more obviousthan lonely use. Conclusion The drug combination of Ningmitai with tamsulosin can be used in clinic for prophylactic purpose to prevent double-J syndrome.

Objective To investigate the prevalence of anxiety and depression among the persons with disabilities in Shanghai and the factors related to them. Methods From November to December, 2014, 731 persons with disabilities were consecutively enrolled in this cross-sectional study. They were assessed with Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). Binary Logistic regression analysis was employed to reveal potential related factors of anxiety and depression. Results The prevalence rates of anxiety and depression among the disabled in Shanghai were 9.58%and 8.48%, respectively. The duration (OR=0.967, P<0.05) and severity (OR<1, P<0.05) of disability were associated with depression, whereas retiral (OR=2.047, P<0.05), living alone or in care unit (OR=3.073, P<0.01) and duration of disability (OR=0.956, P<0.01) were associated with anxiety. Conclusion The frequency of anxiety and depression is mild among the persons with disabilities in Shanghai, and a special intervention is needed.

Objective To evaluate multiple minimally invasive techniques in the treatment of severe acute pancreatitis (SAP).Methods The clinical data of 93 patients with SAP who received minimally invasive treatment at the First Affiliated Hospital of Harbin Medical University from January 2005 to July 2010 were retrospectively analyzed.Percutaneous catheter drainage (PCD),endoscopic retrograde cholangio-pancreatography (ERCP),endoscopic sphincterotomy (EST),endoscopic nasobiliary drainage (ENBD) and laparoscopy were applied according to the condition of the patients.The efficacies of different treatment methods were evaluated.Results On the basis of comprehensive treatment,32 patients received 1 kind of minimally invasive treatment,41 patients received 2 kinds of minimally invasive treatment,14 patients received 3 kinds of minimally invasive treatment and 6 patients received 4 kinds of minimally invasive treatment.Sixty-nine patients received ultrasoundguided PCD; 28 patients received ERCP,EST and (or) ENBD; 29 patients received laparoscopy; 19 patients received treatments with stepped approach; 4 patients were complicated with abdominal bleeding,and received interventional treatment.The mean time of abdominal pain relief and duration of hospital stay were (37 ± 18)hours and (31 ±21 )days,respectively.The abdominal infection rate,laparotomy transfer rate,curative rate and mortality rate were62％(58/93),4％(4/93),91％ (85/93) and 9％ (8/93),respectively.Conclusion Multiple minimally invasive techniques combined with individualized treatment may significantly improve the curative rate of SAP.

Objective To evaluate the diagnostic value of cardiac magnetic resonance imaging (CMRI) for pulmonary arterial hypertension(PAH).MethodsOne hundred and thirty patients with PAH confirmed by right cardiac catheterization were examined by CMRI and the results were compared with that of 31 healthy control participants.The main pulmonary artery diameter( MPAD),aortic diameter( AOD),main pulnonary arterydiameter/aorticdiameter(MPAD/AOD), rightventricular end-diastolicvolume ( RVEDV ),right ventricular end-systolic volume ( RVESV),right ventricular ejection fraction (RVEF) and right ventricular mass (RVM) were measured.The independent samples t-test was used to compare the PAH group with the control group.The Pearson correlation analysis and linear regression analysis were used to evaluate the relationship between cardiac and arterial measurements and pulmonary arterial pressure (PAP).ResultsThe MPAD,MPAD/AOD,RVEDV,RVESV,RVM in PAH group[ (3.88 ±0.57) cm,1.36 ±0.17,(161.63 ±56.37) ml,( 112.61 ±41.46) ml,(82.70 ± 20.73) g,respectively ] were increased compared with those in normal control group[ (2.74 ±0.31 ) cm,0.90 ±0.07,( 131.31 ± 15.14) ml,(61.33±9.00) ml,(44.39±5.87) g,respectively].The RVSV and RVEF in PAH group[(49.02 ±19.20) ml,( 30.76 ± 5.85 ) ％,respectively ] were decreased compared with those in normal control group [ (69.95 ± 9.63 )ml,(53.28 ± 4.14 )％,respectively ].The MPAD,MPAD/AOD,RVEDV,RVESV,RVSV,RVEF,RVM were significantly different between PAH patients and control participants(tMPA =10.82,tMPAD/AOD=14.93,tRVEDV=2.96,tRVESV=6.83,tRVSV=-5.89,tRVEF=-20.22,tRVM=10.12,respectively,P＜0.01).There were no significant correlations between MPAD,RVEDV,RVESV,RVSV and PAP (r=0.299 for MPAD,r =0.127 for RVEDV,r=0.278 for RVESV,r =-0.229 for RVSV).Moderate positive correlations were found between MPAD/AOD, RVM and PAP (r =0.702 for MPAD/AOD,r =0.683 for RVM ).A moderate negative correlation was found between RVEF and PAP (r=-0.660).Conclusion CMRI is an excellent imaging modality for the diagnosis of PAH. The MPAD/AOD,RVM,and RVEF can be used to indicate the severity of PAH.

Objective To explore the incidence and risk factors of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods The clinical data of 72 cases allo-HSCT from Oct 2004 to Dec 2008 were analyzed. Thirteen factors possibly correlated with the development of aGVHD were analyzed. Results aGVHD was developed in 32 cases (44.4 %), in which grades Ⅰ aGVHD was 11.1%, gradesⅡaGVHD was 18.1%, and grades Ⅲ-Ⅳ aGVHD was 15.3 %. The univariate analysis showed that diagnosis, the status of disease, use ATG, conditioning regimen, donor type,ABO blood group disparity between donor and recipient, CD34+ cell number, early engraftment and neutropenic infection, HLA locus were associated with the occurence of aGVHD (P ＜0.1). On the COX regression mode, an increased risk of aGVHD was associated with HLA mismatch (HR =2.58, P ＜0.005), GVHD prophylaxis without ATG (HR =2.94, P ＜ 0.001), and unrelated donor (HR =1.97, P ＜0.01). Conclusion aGVHD is a common complication after allo-HSCT, and HLA mismatch and unrelated donor are independent risk factors for aGVHD.