ObjectiveTo investigate the clinical features and ultrasound imaging characteristics of retroperitoneal fibrosis (RPF),and to find out the value of ultrasound in monitoring the outcome of this disease.MethodsTwelve patients with retroperitoneal fibrosis proven by operation or biopsy were analyzed retrospectively.Their abdominal ultrasound images before and after treatments were studied,especially the severity of renal collecting system separation,the abnormal echo group around the retroperitoneal organs which including the abdominal aorta,the mesenteric artery and vein,the iliac vessels,the inferior vena cava,the bilateral ureters,renal arteries and veins.ResultsAll patients had abnormal separation in renal and ten patients were detected corresponding dilatation in unilateral or bilateral ureters.Seven patients were detected hypoechoic and heterogeneous clumps located in retroperitoneal area,which were around retroperitoneal blood vessels,kidneys or ureters.Three patients received resection to rule out cancer,two patients had ultrasound-guided biopsy and took hormone therapy after diagnosis,seven patients undertook ureteral release surgery and inserted double J stent combined with hormone therapy.Two months later,ultrasound showed the lesions significantly disappeared or reduced size compared with before treatments.It was also found that the majority of patients had hydronephrosis relieved and renal function recovered.Conclusions Ultrasound can help diagnosing retroperitoneal fibrosis,and monitor the outcome of this disease.

Objective To evaluate the methods and the efficacy of interventional therapy for huge aneurysm.Methods Seven patients with huge aneurysm including 2 with pulmonary aneurysm, 2 with renal aneurysm, 1 with humeral artery aneurysm, 1 with right common iliac artery aneurysm, 1 with right internal iliac artery aneurysm. Among these, 5 were true aneurysm, and 2 were pseudoaneurysms caused by congenital, trauma, arteriosclerosis. Three patients were treated with endovascular covered stent graft and 2 patients with embolization containing metallic coils. Two patients were treated with partial aneurysm and feeding artery trunk embolization with metallic coils. Results All 7 patients were successful carried out the interventional therapy with successful rate of 100%. Six aneurysms were completely obstructed with disappearance of symptoms and signs. One died of aneurysm rupture. No other complication occurred.Conclusion Interventional therapy for huge aneurysm is an effective method.

Objective To evaluate the clinical application of a mechanical thrombectomy Straub Rotarex System in peripheral artery.Methods Nine cases,3 men and 6 woman,aged 36-85 years,were included in this study,with 5 of atherosclerosis,and 4 suffering from carcinogenic emboli.All patients were treated with Straub Rotarex System(Straub Rotarex System,patent pending,Straub medical,Wangs,Switzland) under subacute or acute occlusion of lower-limb arteries,including 4 popliteal arteries,3 femoral arteries and 2 iliac arteries,with only one complicated popliteal artery.The lengths of occluded segments were 5.0-13 cm. Results All the thrombi were removed through this intervention accompanied by further bolloon dilation for those greater than 50% stenosis post-operatively,and the arteries were undergone recanalization without any complications.Conclusions Thrombectomy by Straub Rotarex System is safe and effective for patients with peripheral artery occlusion.

Objective To explore the sleep characteristics in first-episode schizophrenics and the effects of olanzapine on body weight and sleep-breathing disorder.Methods 36 first-episode schizophrenics (patient group) and 33 normal controls (control group) were tested with polysomnography(PSG),and compared the difference of PSG,sleep-breathing index and body mass index(BMI) before and after treatment in patient group.Results Before treatment,compared with control group,the patient group had significantly prolonged sleep latency((83.64± 10.62) min vs (29.41 ± 10.05) min),shortened total sleep time ((286.43 ± 17.04) min vs (343.66 ± 16.38)min),decreased sleep efficiency((65.73 ±11.47) vs (86.13 ± 8.15)),increased awake time and arousal number((65.70 ± 10.33) min vs (25.93 ± 9.60) min ; (38.26 ± 6.88) vs (14.40 ± 2.72)) in sleep continuity ; and increased N1 stage ((87.43 ± 11.35) min vs (36.55 ± 6.40) min),decreased N2,N3 stage ((100.53 ± 10.42)minvs (143.35±13.52)min;(49.83±7.51)minvs (87.52±9.74)min) in sleep structure (P ＜ 0.05).After treatment,sleep continuity and sleep structure in patient group were improved,compared with control group,only BMI,arousal index and hypopnea index had statistic difference (P ＜ 0.05).Conclusion The first-episode schizophrenics have both sleep continuity and sleep structure deficits.Although olanzapine treatment can improve sleep quality,long-term use of it may cause overweight and sleep-breathing disorder.

Objective To observe the value of virtual tough tissue imaging quantification (VTIQ) in differential diagnosis of thyroid imaging reporting and data system(TI-RADS) 4 thyroid nodules.Methods A total of 185 patients with 192 TI-RADS 4 nodules were included in this study.The nodules were divided into three groups according to the maximum size as follows:Group Ⅰ,the maximum size≤0.6 cm;Group Ⅱ,0.6 cm＜ the maximum size≤ 1.0 cm;Group Ⅲ,the maximum size ＞ 1.0 cm.Shear wave velocities (SWV) of nodules were measured by means of VTIQ technique.With pathological diagnosis as the gold standard,SWV value of benign and malignant nodules were analyzed and ROC curve was drawn to assess the diagnostic efficiency.Results By the ROC curve test,at SWV cut-off values of 2.44 m/s for group Ⅰ and group Ⅱ,2.49 m/s for group Ⅲ,the sensitivity were 79.0 ％,76.0 ％,88.6％,specificity were 88.6％,89.5 ％,93.7 ％,accuracy were 83.5 ％,81.8 ％,90.1％,Youden index were 0.68,0.66,0.82,respectively.Conclusions VTIQ can reflect the hardness of TI-RADS 4 nodules,the value of the differential diagnosis of such nodules is high,convenient,noninvasive and not limited by the size of nodules.

Objective To investigate the miss rate of adenoma with colonoscopy and assess the features and risk factors for missed diagnosis.Methods Patients with colorectal adenoma received a second colonoscopy within 120 days after adenoma was detected and removed on the initial colonoscopy.The findings of two colonoscopies were reviewed and analyzed.The features of adenoma (including size, location, shape, number and pathology) , clinical characteristics of patients (including age, sex, reasons of colonoscopy, history of diverticular disease, history of abdominal or pelvic surgery and colonoscopy with sedation) and endoscopists were recorded.Miss rate and features of different types of missed adenoma were analyzed.We also assessed the effects of adenoma features, patients' characteristics and endoscopists on missed diagnosis of adenoma.Results Adenoma missed diagnosis was found in 271 patients out of 809 recruited subjects (33% ).A total of 425 adenomas were missed out of 2134 (20% ) adenomas detected by repeated colonoscopy.A large diameter was associated with a decrease in the miss rate for adenoma (P < 0.01).Conversely , sessile or flat shape (P < 0.01) , locations at sigmoid, hepatic flexure, cecum and ascending colonic ( P < 0.05) were significantly associated with a higher miss rate of adenoma, as was the number of adenomas (P <0.01).A higher adenoma missed diagnosis rate was observed in beginner colonoscopists, as compared with experienced ones (P < 0.01).Conclusion A marked miss rate of adenoma exists on colonoscopy, which is significantly associated with the size, shape, location and number of adenomas and endoscopists.

Objective To explore the correlation between TOP2A gene expression and TCM constitutional types of patients with triple-negative breast cancer.Methods The questionnaire for constitution of Chinese medicine was used to identify the TCM constitutional types of 71 patients with triple-negative breast cancer and TOP2A gene alterations were quantified by real-time PCR. 2-ΔΔCt was used to analyze the expressions of each group. SPSS17.0 was employed to analyze the correlation between TOP2A gene amplification and TCM constitutional types.Results Totally 71 patients were divided into general type (0 case), Qi deficiency type (18 cases), Yang deficiency type (10 cases), Yin deficiency type (12 cases), Qi stagnancy type (7 cases), blood stasis type (10 cases), phlegm wet calculus type (8 cases), damp-heat type (6 cases), and special type (0 case). All of them were biased constitutional types, of which Qi deficiency constitution (25.35%), Yin deficiency constitution (16.90%), blood stasis constitution (14.08%) took the majority. TOP2A gene amplification was negative correlated with each constitutional type (P<0.05).Conclusion Biased constitutional types were the main types of TCM constitutional type of patients with triple-negative breast cancer. The main three biased constitutional types of triple-negative breast cancer were Qi deficiency constitution, Yin deficiency constitution and blood stasis constitution. TOP2A gene expression in patients with triple-negative breast cancer was normal or less expressed, which predicted low chemotherapy sensitivity and poor prognosis.

Objective To investigate the predictive value of rectal aberrant crypt foci(ACF)for colorectal cancer(CRC)and progressive adenomas, and to analyze its risk factors.Methods IndependentSample T test, One-Way ANOVA and Chi-square test were used to analyze the mean number and incidence of rectal ACF.Logistic regression analysis was used to assess the predictive value of rectal ACF for progressive adenomas and CRC, and to identify the independent risk factors of ACF.Results Large number of ACF, i.e.more than 5, was a significant risk factor for CRC and progressive adenomas.Age and smoking were both risk factors of ACF, while aspirin was a protective factor.Conclusion ACF of more than 5 is predictive of CRC and progressive adenomas.For prevention of CRC, great importance must be attached to risk factors of ACF.

Objective To sequence and analyze the envelope (E) gene of type Ⅰ dengue virus isolated from Guangzhou in 2009 for tracing the infection source. Methods The serum samples were collected from patients diagnosed with dengue fever in Guangzhou area during 2009. Dengue virus was isolated and cultured in C6/36 cells.The whole length of E gene was amplified by reverse transcriptase-polymerase chain reaction (RT-PCR) and then sequenced. The phylogenetic tree was drawn by neighbor-joining method. The bioinformatics analysis was performed by combining the phylogenetic information and the epidemiology data. Results Four strains of type Ⅰ dengue virus were isolated from 19 samples. E gene of these strains was amplified and sequenced. The phylogenetic analysis showed that 09/GZ/9104 strain and 09/GZ/9236 strain had identical nucleotide sequence and fell within the American/African group, 09/GZ/11534 stain and 09/GZ/11562 strain had similar sequence homology and fell within the Asian group. Conclusion The typeⅠdengue viruses in Guangzhou area in 2009 are imported, which belong to two genotypes and may come from two independent origins respectively.

Objective To evaluate the feasibility and therapeutic efficacy of real-time virtual navigation system (RVS) combined with contrast-enhanced ultrasonography (CEUS) for hepatocellular carcinoma undetectable by conventional ultrasound and CEUS.Methods A total of 213 patients with 265 lesions (undetectable on conventional ultrasound but detectable by other imaging examinations) were enrolled in this study.CEUS was performed,and lesions which were detected with CEUS were given CEUS guided radio-frequency ablation (RFA) (CEUS group).RVS combined with CEUS was performed to locate the rest lesions and guide RFA (RVS + CEUS group).Diagnostic value and therapeutic efficacy of RVS + CEUS were assessed.Results In 256 lesions,174 (65.7％) could be detected with CEUS,and among the rest 91 lesions,82 (90.1％) lesions could be detected by RVS combined with CEUS.The technique effectiveness rate of RVS + CEUS was significantly higher than that of CEUS (x2 =18.85,P ＜0.0001).Complete ablation rate after one month in RVS+ CEUS group was 9t.5％ (75/82),which was significantly higher than that in CEUS group [86.2％ (150/174),P ＜0.05].Local progression in one year in CEUS group and RVS + CEUS group were 13.4％ and 10.9％,respectively.Conclusions RVS combined with CEUS is feasible for hepatocellular carcinoma undetectable by conventional ultrasonography and CEUS,and the therapeutic efficacy of RVS + CEUS guided RFA is satisfactory.