Objective To analyze and evaluate the image quality and the impact factors of CT virtual endoscopy (CTVE) in the application of various body parts. Methods CTVE images from 143 patients were classified into 2 types according to the chosen threshold: low attenuation lumen (including natural air filled and artificially air filled lumina) and high attenuation lumen. A 4 point scale was used to evaluate the differences of diagnostic confidence, artifacts, and overall image quality rating between both kinds of lumina. Results There was no statistically significant differences in diagnostic confidence of CTVE images among 3 kinds of lumina, but the image quality of CTVE of natural air filled lumen was better than that of artificially air filled lumen ( P 0.05). There was a significant difference in artifact rating of CTVE images among three kinds of lumina with the most artifacts seen on images of high attenuation lumen. Common artifacts observed on the CTVE images were attributed to patient motion artifacts such as respiration, inappropriate choice of spiral CT scanning parameters, and improper modification of thresholds. Conclusion The threshold setting was one of the most important factors impacting the image quality of CTVE images, and most artifacts seen on the CTVE images were easily recognized on the basis of their characteristic appearance, and did not influence the diagnostic information heavily.

0.05), but the lesion detection sensitivity of SSD and Raysum display were lower than that of UGI(? 2=4.17,7.11, and 5.14,4.17, P0.05). Excess fluid remained in the stomach and patient respiratory movement during breath holds were the reasons causing severe artifacts (6.1%) that influenced the diagnostic evaluation. Conclusion The performance of CTVG was equivalent to UGI in the detection of advanced gastric carcinoma and superior to UGI in the Borrmann′s classification. CTVG has potential in the detection of early gastric carcinoma. The value of SSD and Raysum display was limited in the evaluation of gastric carcinoma when used alone clinically.

OBJECTIVETo investigate the methods of lesion localization and surgical treatment for non-palpable breast cancer, presented with only small calcification lesion on the images.

METHODSFrom November 2003 to August 2007, 61 patients with non-palpable lesion were finally pathologically diagnosed as early breast cancer (T1-2N0M0), based on the small calcification lesions shown by full field digital mammography (FFDM) through molybdenum target, and the rich blood supply shown by type-B ultrasonic examination. Accurate lesion-localization prior to surgical resection was conducted, and sample re-examination by FFDM was done after resection. Patients with single lesion underwent breast-conserving surgery, precise excision with the aid of image-guided wire localization, and stage I breast reconstruction was performed simultaneously using wide-based gland-tissue flap. Patients with multiple lesions received modified radical mastectomy.

RESULTSAmong the 50 patients treated with breast-conserving surgery, the accuracy of localization for lesions was 100% (50/50), and all lesions were excised completely with a negative margin proven by FFDM re-examination and pathological examination. The superior rate of mammaplasty was 86.0% (43/50) according to JCRT criteria, with a compliance difference of 1.5 cm. Modified radical mastectomy was performed in 11 patients. The follow-up period in this series was from 6 to 58 months with a mean follow-up time of 39 months. Distant metastases were detected in only one patient and local recurrence was not observed yet.

CONCLUSIONLesion localization by FFDM in patients with non-palpable breast cancer is accurate and practical. In patients with single lesion, breast-conserving resection followed by synchronous stage I breast reconstruction with wide-based gland-tissue flap is appropriate.

Adult ; Aged ; Breast Neoplasms ; diagnostic imaging ; pathology ; surgery ; Carcinoma in Situ ; diagnostic imaging ; pathology ; surgery ; Carcinoma, Ductal, Breast ; diagnostic imaging ; pathology ; surgery ; Carcinoma, Papillary ; diagnostic imaging ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Mammography ; methods ; Mastectomy, Modified Radical ; Mastectomy, Segmental ; Middle Aged ; Neoplasm Staging ; Palpation

OBJECTIVETo analyze the alterations of serum proteomic pattern in esophageal squamous cell carcinoma (ESCC) by SELDI-TOF-MS, to establish a diagnostic model of ESCC screening in high incidence area and investigate its clinical value.

METHODSSELDI-TOF-MS and CM10 proteinChip were used to detect the serum proteomic patterns of 36 cases of ESCC and 38 healthy control subjects in high incidence area. The data were analyzed and a diagnostic model was established by using support vector machine (SVM). The diagnostic model was evaluated by leave-one-out cross validation.

RESULTSAt the molecular weight range of 2000 to 20,000, 31 protein peaks were significantly different between ESCC and controls (P < 0.01). A diagnostic model consisting of 4 protein peaks could do the best in diagnosis of ESCC and controls. The accuracy was 85.1%, sensitivity was 86.1%, specificity was 84.2%, and positive value was 83.8%.

CONCLUSIONThe diagnostic model formed by 4 protein peaks, established in this study, can well distinguish ESCC from healthy subjects. It provides a new approach for ESCC screening in high incidence area.

Adult ; Aged ; Blood Proteins ; analysis ; chemistry ; Carcinoma, Squamous Cell ; blood ; diagnosis ; epidemiology ; China ; epidemiology ; Esophageal Neoplasms ; blood ; diagnosis ; epidemiology ; Humans ; Incidence ; Mass Screening ; Middle Aged ; Peptide Mapping ; Protein Array Analysis ; Proteomics ; methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Objective: To explore the clinical efficacy and safety of unrelated umbilical cord blood transplantation (UCBT) in the treatment of refractory and relapsed acute leukemia (AL) patients. Methods: The clinical data of 22 refractory and relapsed AL patients who were treated with UCBT as salvage therapy from November 2009 to May 2017 were retrospectively analyzed. All patients received a myeloablative conditioning regimen for prevention of graft-versus-host disease (GVHD) with cyclosporine A (CSA)/short course of mycophenolate mofetil (MMF). Results: ①Of 22 patients, 9 cases were male and 13 female. The median age was 23 (15-44) years and median weight of 52.5 (43-82) kg. All patients were transplanted with a median umbilical cord blood nucleated cells of 3.07 (1.71-5.30)×10⁷/kg (by weight), the median CD34⁺ cells was 1.60 (0.63-3.04)×10⁵/kg (by weight). ②The myeloid cumulative implantation rate was 95.5% (95%CI 45.2-99.7%) after transplantation of 42 d, with the median implantation time of 19 (13-27) d. The platelet cumulative implantation rate after transplantation of 120 d was 81.8% (95%CI 54.2-93.6%), the median implantation time of 42 (20-164) d. ③The incidence of Ⅱ-Ⅳ, Ⅲ-Ⅳ aGVHD and the 2 year cumulative incidence of cGVHD were 36.4%, 13.6% and 40.3% respectively. ④ The transplant related mortality (TRM) after transplantation of 180d was 22.7%, 2 year cumulative rate of relapse was 18.7% (95%CI 3.6-42.5%), 2 year disease-free survival rate (DFS) and overall survival rate (OS) were 53.7% and 58.1%, respectively. Conclusion: The preliminary results show that the use of UCBT is safe and effective for refractory and relapsed AL patients who fail to respond to conventional chemotherapy.
Acute Disease ; Adolescent ; Adult ; Cord Blood Stem Cell Transplantation ; Female ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia/therapy* ; Male ; Peripheral Blood Stem Cell Transplantation ; Retrospective Studies ; Transplantation Conditioning ; Young Adult

【Objective】To explore the feasibility and simplicity of intelligent automatic registration ultrasound-CT/ MR fusion imaging based on liver surface in localization of focal liver lesions. 【Methods】 Thirty patients with detected focal liver lesions by contrast- enhanced CT or MR were enrolled for ultrasound- CT/MR fusion imaging using the PercuNav fusion imaging system in PHILPS EPIQ7. Both intelligent automatic registration ultrasound- CT/MR fusion imaging based on liver surface（intelligent method）and the conventional internal plane method（manual method）were used for ultrasound-CT/MR fusion imaging. The success rate of registration，the initial registration error and the times of fine-tuning were compared between these two methods.【Results】In all 30 patients，the success rates of registration were both 96.67%（29/30）using intelligent method and manual method. There was no significant difference between these two methods when compared the initial registration error and the times of fine- tuning （P>0.05）. According to the further stratified analysis，in 10 lesions in the left liver，the initial registration error of the manual method was less than that of intelligent method，the difference was statistically significant（P=0.00）. Although the times of fine-tuning of the manual method was less than that of intelligent method，there was no statistically significant difference（P=0.09）；In 20 lesions in the right liver，the initial registration error and the times of fine-tuning of the intelligent method were superior to those of the manual method. The differences were statistically significant （P<0.05）. 【Conclusion】 Intelligent automatic registration ultrasound- CT/MR fusion imaging based on liver surface is a feasible method with high success rate for ultrasound-CT/MR fusion imaging. Compared with the conventional internal plane method，the fusion imaging process is more simple and efficient for the lesions in right liver. It helps to reduce experience dependence of fusion imaging for the operators.