This paper reports 32 patients with primary esophageal small cell undifferentiated carcinoma confirmed by histologic examination from April 1972 to January 1989 in our hospital. The 1-, and 3-, 5-year survival rates were 53.1%, 18.8% and 6.3%. 93.7% patients died of local un-control, recurrence or metastasis. The age, sex, tumor size, stenosis, position and the type in X-films did not influence the treatment results. Patients with primary esophageal small cell undifferentiated carcinoma should receive a multimodal treatment instead of surgery alone.

Adenomyomatosis of the gallbladder (GAM) is an acquired,benign proliferative lesion of the gallbladder which is characterized by mucosal proliferation with invaginations and diverticula penetrating into the thickened muscular layer (Rokitansky-Aschoff sinuses).GAM consists of 3 types:diffuse,segmental and fundus GAM.There is no specific presentation of GAM,and computed tomography is helpful for the diagnosis of this disease.From July 2010 to May 2013,16 patients with fundus GAM were admitted to the Second People's Hospital of Wuxi.Rokitansky-Aschoff sinuses and calotte sign at the thickened muscular layer of the fundus of the gallbladder are the typical presentation of the fundus GAM.Enhanced computed tomography examination is of great importance for the diagnosis of the fundus GAM.

Objective: To assess the renal cortical perfusion parameters by the imaging of computed tomography (CT) in patients of essential hypertension (EH) with target organ damage.
Methods: A total of 90 subjects with the entire information including 59 EH patients were studied. The EH patients were divided into 2 groups: EH + target organ damage group,n=30 and EH without target organ damage group,n=29. In addition, there was a Control group,n=31 healthy volunteers. All subjects received 128-slice dual-source CT renal perfusion scanning, the quantitative perfusion of renal cortex blood lfow (BF), blood volume (BV), time to peak (TTP) and the mean transit time (MTT) were examined and compared among different groups.
Results: There were 90/97 (92.8%) participants eligible for perfusion analysis. Compared to Control group, EH without target organ damage group had the similar parameters of BF, BV, MTT and TTP,P>0.05. While EH + target organ damage group had decreased BF (214.6 ± 36.1) ml/(min?100 ml ) than Control group (262.1 ± 26.6) ml/(min?100 ml ),P<0.01, and BV, TTP, MTT were similar to Control group,P>0.05. Compared to EH without target organ damage group, the EH + target organ damage group presented decreased BF (214.6 ±3 6.1) ml/(min?100 ml ) vs (268.9 ± 33.1) ml/(min?100 ml ), P<0.01 and prolonged MTT, TTP,P< 0.05.
Conclusion: CT imaging may evaluate the renal cortical perfusion changes, and especially BF which can relfect the renal perfusion more sensitively than other parameters in EH + target organ damage patients.

Objective: To quantitatively study the incidental extra-cardiac ifndings (ECFs) by coronary computed tomography angiography (CCTA) in patients with suspected coronary artery disease (CAD) in order to better recognize those lesions in clinical practice.
Methods: A total of 1169 suspected CAD patients received CCTA in our hospital from 2011-06 to 2013-03 and 1030 patients were enrolled in this study. There were 589 in-patients, 441 out-patients and 549 patients≥60 years of age,481 patients < 60 years of age. 3 physicians evaluated the incidental ECFs in the full ifeld of view (FOV) in different window level and window width for lung, mediastinum, thorax and upper abdominal areas. Clinical relevance of ECFs were classiifed by corresponding scores. Score 1, the patients with severe lesion need immediate treatment, score 2, the lesion with clinical and prognostic signiifcance and score 3, the ifnding without clinical signiifcance.
Results: There were 197/1030 (19.1%) patients having 224 ECFs and 27 (2.6%) patients having 2 ECFs; 90/1030 (8.7%) patients having 106 signiifcant lesions including 3 (0.3%) of lung cancer and 8 (0.8%) of pulmonary embolism; 107 patients with 118 lesions without signiifcance. ECFs were found in 114/589 (19.4%) in-patients and in 83/441 (18.8%) out-patients, P>0.05; 76/481 (15.8%) of patients < 60 years of age and 121/549 (22.0%) of patients≥60 years,P<0.05.
Conclusion: Unexpected ECFs detection rate was 19.1% in patients undergoing CCTA without further radiation exposure by reconstruction with the full FOV setting, and 8.7% of ECFs had clinical signiifcance. Radiologists should routinely analyze the extra-cardiac organs in CCTA.

Objective To investigate the expression and distribution of basic fibroblast growth factor (bFGF)and platelet-derived growth factor (PDGF)in the different phases of femoral neck fracture.Methods Immunohistochemical assays were used to determine the expression and distribution of bFGF and PDGF protein in 36 human specimen of femoral neck fracture.A was measured and analyzed by CMIAS color imaging analysis system for signals of bFGF protein were found high in the mesenchymal cells,monocyte and vascular endothelial cells at 1st week after fracture in 9 subjects,with A of (0.4076 ±0.0902).The weakly positive signals of PDGF protein were found in the mesenchymal cells,while strongly positive in the vascular endothelial cells with A of (0.2261 ±0.0636).At 2rd week,in 9 cases the expression of bFGF and PDGF was strongly expressed in fibroblasts,endothelial cells,cartilage cell and cartilage matrix,osteoblast,with A of[(0.6404±0.0920)and (0.7457±0.0756)]and significandy higher than that at 1st week (P＜0.05,P＜0.01).There was no significant difference between the 3rd and 3nd week with A of[(0.7168±0.1346)and (0.8033±0.0491),P＞0.05 ].The expression of bFGF and PDGF protein was reduced obviously at 4th week but was positive in young and cartilage tissue,with A of [(0.5374correlation between bFGF and PDGF protein in different phases (r1week=0.792,r2week=0.834,r3week=0.880,entiation of cartilage cell and osteoblast,and induce proliferation of vascular endothelial cells and new blood vessel.③ Both bFGF and PDGF are bone growth factors, cooperating in regulating proliferation and differentiation of cartilage cell and osteoblast for fracture healing.

Objective:To assess the role of EGFR mutations on pemetrexed response in patients with advanced lung adenocarcino-ma. Method: Forty pulmonary adenocarcinoma patients with evaluable lesions were retrospectively screened .They had been treated with pemetrexed-included chemotherapy and had EGFR gene test results. The evaluation endpoints were overall response rate,disease control rate and progression free survival. Result:No significant statistical difference was seen in overall response rate(ORR) (44.4%VS 31.8%, respectively) and disease control rate(DCR) (88.9%VS 81.8%, respectively ) between EGFR wild group and EGFR muta-tion group, but patients in EGFR wild group had longer progression free survival(PFS) ( 8.9 months VS 5.3 months;P=0.046). Conclu-sion:EGFR mutation status can influence the efficacy of pemetrexed.

Objective To investigate whether MT1-MMP is involved in the inhibition effect of curcumin on the proliferation and invasion of breast cancer cell and the mechanism . Methods Firstly, MCF-7 cell lines transfected by MT1-MMP eukaryotic expression vector was established. We divided all cells into 3 groups,including null vector transfection group, non-transfected and transfected group with different concentrations of curcumin. The expression of MT1-MMP protein, the proliferation and invasion ability were respectively analyzed by western blot, transwell method, and cell counting kit-8 (CCK-8). Results The expression of MT1-MMP was inhibited by curcumin. Transwell and CCK-8 experiment indicated the proliferation and invasion abilities of MT1-MMP transfected MCF-7 cells were inhibited by curcumin in a concentration dependent manner. Conclusion The inhibition value of curcumin on proliferation and invasion is probably due to its ability to inhibit the expression of MT1-MMP.

Heart Atria ; Humans ; Lung Neoplasms ; Sarcoma ; Skull Neoplasms

Objective To study the radiologic features and the diagnostic value of multi-slice spiral CT (Multi-slice CT, MSCT) in cholecysto-duodenal fistula.Methods A retrospective analysis was conducted on 33 patients with cholecysto-duodenum fistula.Plain and IV enhanced MSCT were carried out on these patients.Results Of the 33 patients, the fistula was located at the duodenal bulb in 15 patients (45.5％) , the junction of the bulb and the descending part of the duodenum in 3 patients (9.1％) , the horizontal part in 5 patients (15.1％) and the ascending of the duodenum in 10 patients (30.3％).The CT signs of cholecysto-duodenum fistula included in 16 cases.The fistulae were clearly displayed including some fistulae being dumbbell-shaped.The indirect signs of cholecysto-duodenum fistula included in 2 cases the gallbladders were unclearly shown.In 1 case the gallbladder volume increased because of cancer and in another case because of acute cholecystitis.In 29 cases, the gallbladder volume was significantly reduced,with an average volume which ranged from 6 cm × 2 cm to 2 cm × 1 cm, and an average gallbladder wall thickening of 5 cm.There were extensive adhesions between the gallbladder and duodenum with visible effusion.In 26 cases, gas was present in the biliary system with 22 cases showing gallbladder gas, and 19 cases showing biliary pneumatosis.Biliary stones were present in 26 patients (gallbladder stones in 22 cases, gallbladder neck stones in 6 cases, common bile duct stones in 13 cases).At the site between the duodenum and the gallbladder there were radiological changes simulating a diverticulum.In 11 cases the changes were like a duodenal diverticula.The complications of cholecysto-duodenal fistula included 5 cases of gallstone ileus and 2 cases of multiple liver abscesses.Conclusions MSCT is important in depicting presence and location of cholecysto-duodenal fistula.The morphology and shape of the gallbladder, the presence of gas in the biliary system, the presence of stones and the surrounding adhesions could be fully demonstrated by MSCT.MSCT are important for diagnosing cholecysto-duodenal fistula and in the planning of surgery.

Objective To evaluate the diagnostic value of myeloperoxidase (MPO)in diagnosis of non-ST elevation acute cor-onary syndromes (NSTE ACS).Methods The MPO was determined in 61 unstable angina pectoris (UAP)patients and 54 non-ST-elevation myocardial infarction (NSTE MI)patients,then analyzed the data with receiver operationg characteristic curve (ROC curve)statistical software.The major adverse cardiac events (MACE)were obseved in 106 NSTE ACS patients through 1 year of follow-up.Results The MPO values of NSTE MI group and UAP group were 672±418 ng/ml and 459± 328 ng/ml,the difference was statistically significant (t=3.928,P <0.001).The cTnI values were 558±261 pg/ml and 405 ±278 pg/ml of respectively.The difference was statistically significant (t = 3.089,P = 0.003).The area under the ROC curve of MPO was 0.726 when the optimal cutoff value was 382 ng/ml in the diagnosis of NSTE MI.The sensitivity and specificity was 92.6% and 39.8%.The area under the ROC curve of cTnI was 0.799 when the optimal cutoff value was 484 ng/ml in the diagnosis of NSTE MI.The sensitivity and specificity was 65.5% and 92.3%.High MPO maintained a strong association with the risk of major adverse cardiac events through 1 year of follow-up.Conclussion MPO is ahigh sensitivity marker of the NSTE MI and of clinical value for prognosis of NSTE ACS.