Objective　To improve the recognition of the imaging appearances of inflammatory pseudotumors of the spleen (IPS), 3 cases with IPS were reported. Methods　The US (n=3), CT (n=3) and MRI (n=1) findings of IPS were reviewed and correlated with the pathologic findings. Results　On US, a well-defined solitary mass with heterogeneous echo texture was found in all 3 cases. A hyperechoic rim with associated acoustic shadowing was shown in 1 case. In all of the 3 cases in nonenhanced CT scanning, a well-defined hypoattenuated mass was found. One had a calcified egg-shell-like rim; On the venous/delayed phase of enhanced CT after contrast administration in 2 cases, slight/marked enhancement was shown. On nonenhanced MRI in 1 case, the mass was shown as heterogeneous hypointensity on T1- and T2- weighted images. Conclusion　IPS should be included in the differented diagnosis of solitary mass lesion of spleen. The imaging findings depend on the variable proportions of fibrous and granulomatous components within the lesion. IPS was characterized by well-defined solitary mass on sonogram, delayed enhancement on enhanced CT, and hypointensity on T2 weighted MR images.

Objective To study the CT manifestations of metastatic lymph node of thyroid carcinoma. Methods CT appearances of metastatic lymph node of thyroid carcinoma proved by surgery and pathology in 108 patients were reviewed. Results Of these 108 cases, metastatic lymph nodes were located at superoir and middle internal jugular chain(n=76), inferior internal jugular chain and super clavicular region(n=86), tracheoesophageal groove(n=52), and superior mediastinum(n=17). Of 84 thyroid papillary carcinoma patients, the attenuation of metastatic lymph nodes were similar to that of normal thyroid gland(n=16), with cystic formations (n=24), intracystic high attenuation papillary-like nodules (n=18), and fine granular calcifications (n=11). Of 24 follicular carcinoma, medullary carcinoma, and clear cell carcinoma patients, 17 cases had significant homogeneous or heterogeneous enhanced nodes, and the attenuation was the same as primary or recurrent thyroid tumors. Conclusion For thyroid carcinoma, the most common locations of metastatic lymph nodes were internal jugular chain, tracheoesophageal groove, and superior mediastinum regions. Marked enhancement similar to normal thyroid gland, cystic formations with intracystic high attenuation papillary-like nodules, and fine discrete granular calcifications were the characteristic manifestations of metastatic lymph node of papillary carcinoma. Marked homogeneous or heterogeneous enhancement after contrast administration and the same attenuation as the primary or recurrent thyroid tumor were found in follicular carcinoma, medullary carcinoma, and clear cell carcinoma metastases.

Objective To evaluate the contrast enhanced CT manifestations of lymphoma involving cervical lymph node and to compare with features of metastatic squamous cell carcinoma. Methods CT findings of cervical lymph node were reviewed in 56 patients (male 44, female 12; age: 9-75 year, median 42 year) with untreated lymphoma and 66 patients (male 51, female 15; age: 16-76 year, median 48 year) with squamous cell carcinoma. Four patterns of enhanced nodes were identified: Type I: homogeneous enhancement with an attenuation equal or similar to that of muscle. Type Ⅱ: heterogeneous enhancement with an attenuation much higher than that of muscle. Type Ⅲ: central low density with peripheral enhancement. The enhanced rim was thick and irregular (ⅢA), or thin and regular (ⅢB). Type Ⅳ: central soft tissue density with a very thin enhanced capsule. Results There were various manifestations of cervical nodes of malignant lymphoma, more than one type of abnormalities could be found simultaneously. Type I(47/56, 83.9%) and Type Ⅳ(15/56, 26 8%) were almost exclusively found in lymphoma. Type Ⅱ was more commonly seen in squamous cell carcinoma (31/66, 47%), but was rarely seen in lymphoma (8/56, 14 3%). Type Ⅲ can be seen in both of these disease entities (lymphoma 21/56, 37 5%; squamous cell carcinoma 52/66, 78 8%) , but was more common in squamous cell carcinoma ( P

Objective To study the radiographic features of pulmonary sclerosing hemangioma (PSH), and to correlate the imaging with the pathologic findings so as to improve the imaging diagnostic abilities. Methods The clinical features of 45 patients with pathology proved PSH between 1976 and 2002 were reviewed. Of the 45 patients, there were 3 men and 42 women, their age ranged from 18 to 67 years (median age, 49 years), and 19 patients were asymptomatic. 20 patients had chest radiography and CT scans. The radiographic findings were studied retrospectively and were correlated with that of pathology. (7 patients) underwent unenhanced CT and 13 patients had enhanced CT. Results Of the 20 patients who had chest X-ray, 18 patients presented as a solitary, round or oval shaped lesion with well-defined margin. On CT scans, the greatest dimension of the lesion ranged from 1.9 cm to 7.0 cm. A homogeneous soft-tissue attenuation was revealed on unenhanced scans. Homogeneous enhancement was detected in 9 patients and heterogeneous enhancement in 4 patients on enhanced CT. Cystic change was found in 1 patient showing lower attenuation than the enhanced solid tumor, and calcification was found in 5 patients. Correlation of radiographic and pathologic findings indicated that higher attenuation areas corresponded to the angiomatous areas. Conclusions PSH should be considered with the following features: (1) female patients between (40-60) years of age; (2) well-defined round or oval shaped lesion on chest radiography; (3) a homogeneous soft-tissue mass on unenhanced CT; cystic-like area within the tumor and/or calcification can occasionally be found; (4) homogeneous or heterogeneous enhancement after contrast administration.

Objective To investigate the effect of mycophenolic acid on the proliferation of smooth muscle cells (SMCs) in rats' pulmonary arterial at cellular level. Methods Growth curve, MTT tests, and flow cytometry were used to detect the number of proliferative cells, the A-value of living cells and the DNA content of the control and drugs groups respectively and the number of cells in G1-phase, S-phase, G2M- phase and the proliferation index were calculated. Results Compared with the control group, the number of living cells in the mycopbenolic acid groups (with the concentration of 1, 10, 100 μmol/L) decreased, except the lowest dosage group (100 nmol/L). The difference was statistically significant (P<0.01). The living cells measured by MTT dose-dependently reduced in the mycophenolic acid groups. In the mycophenolic acid groups, the fraction of living cells in the S-phase and G2M-phase decreased respectively while that in G1- phase increased, and the proliferation index decreased. All these responses presented with a dose-dependent manner. Conclusion Mycophenolic acid can effectively inhibit the proliferation of rats' pulmonary arterial SMCs. This process happens mainly in ONA synthesis phase, and is dose dependent. In addition, these effective concentrations are all in the available range for clinical application.

Objective To investigate the effects of the interaction between human hepatoma cells and hepatic stellate cells on their growth state,and study its role of interaction on the progression of hepatocellular carcinoma.Methods Human hepatoma cell line HepG2 and hepatic stellate cell line hepatic stallate cells (HSC)-T6 were used and the methods including methyl thiazolyl tetrazolium (MTT) assay,flow cytometry (FCM) analysis,immunohistochemistry,and electron microscopy were employed in this experiment.The effects of conditioned medium (CM) of HepG2 on the activation and proliferation of HSC were explored.The effects of activated HSC CM on HepG2 proliferation were investigated.The uhrastructural changes of the two co-cultured cells were observed.Results MTT assay result showed that HepG2/HSC CM could promote HSC/HepG2 proliferation.FCM result demonstrated that HepG2/HSC CM could influence the cell cycle distribution in HSC/HepG2.Immunohistochemistry exhibited that after the treatment of HepG2/HSC CM,the expression ofα-smooth muscle actin (α-SMA) in HSC and proliferating cell nuclear antigen (PCNA) in HepG2 were increased.When HepG2 and HSC were co-cultured,the ultrastructure of HSC displayed an activated feature.Conclusions HepG2 cells can induce the activation and proliferation of HSC,and the activated HSC can also stimulate the proliferation of HepG2.Interaction between hepatoma cells and hepatic stellate cells may play an important role in the progression of hepatocellular carcinoma.

OBJECTIVETo analyze the distribution of matrix metalloproteinase-3 (MMP-3) genotype and its association with the blood pressure profiles in Guangzhou rural population.

METHODSThis study was conducted among 680 rural residents aged 40-70 years (including 314 men and 366 women) from 3 villages in an rural area of Guangzhou. The blood pressures of the subjects were measured and blood samples were collected for genotype analysis using polymerase chain reaction and direct sequencing of the MMP-3 gene promoter region to detect the 5 adenines (5A)/6 adenines (6A) polymorphisms.

RESULTSThe frequencies of MMP-3 genotypes 6A/6A, 5A/5A, and 5A/6A were 82.6%, 1.8% and 15.6% among these residents, respectively. The distribution of MMP-3 genotypes and allele frequencies showed no significant gender- or age-related variations. The men with different genotypes (6A/6A vs 5A/6A+5A/5A) did not show significant differences in blood pressure levels, whereas the women with 5A/6A+5A/5A genotypes had higher systolic and diastolic blood pressures than those with a 6A/6A genotype. The allele 5A was highly frequent in the hypertensive residents as compared with the normotensive residents.

CONCLUSIONSThe 6A homozygote is the predominant genotype of MMP-3 in Guangzhou rural population, which has a significantly lower proportion of 5A homozygote than the Western populations. The 5A allele is associated with a high risk of hypertension especially in women and may affect both systolic and diastolic blood pressures.

Adult ; Age Distribution ; Aged ; Alleles ; Blood Pressure ; China ; epidemiology ; Female ; Gene Frequency ; Genotype ; Humans ; Hypertension ; epidemiology ; genetics ; Male ; Matrix Metalloproteinase 3 ; genetics ; Middle Aged ; Risk Factors ; Rural Population ; Sex Distribution

Objective To assess the efficacy and safety of mifepristone combined with oral or vaginal misoprostol for termination of pregnancy between 8 and 16 weeks of gestation. Methods This was a randomized, multi-center, open clinical trial. A total of 625 women at 8-16 weeks of gestation were randomized to receive 200 mg oral mifepristone followed by either oral misoprostol 400 μg every 3 hours or vaginal misoprostol 400μg every 6 hours for a maximum of 4 doses 36-48 hours later. There were 417 women in oral group with 198 at 8-9 weeks and 219 at 10-16 weeks, while 208 women in vaginal group with 99 at 8-9 weeks and 109 at 10-16 weeks. The outcome measures were the success abortion rate, induction to abortion interval, the amount of bleeding, reoccurrence of menstruation and adverse events. Results Abortion rate was significantly higher in vaginal group [98.1% (202/206)] than that in oral group [94.0%(390/415), P=0.023]; concerning termination of pregnancy at 8-9 weeks and 10-16 weeks respectively, there were no significant differences between oral and vaginal groups (P=0.156, P=0.073). The induction to abortion interval was no significant difference in oral and vaginal group in different gestational weeks ( P=0.238, P=0.273). The average induction to abortion interval was (4.1 ± 6.6) hours and (6.0 ± 4.5) hours respectively in terminating 8-9 weeks and 10-16 weeks of gestation. Concerning the amount of bleeding within 2 hours of placenta expulsion, there was significant difference between oral group [(63±46) ml] and vaginal group [(55 ± 45) ml] in terminating 8-9 weeks of gestation (P=0.047), while there was no significant difference between groups in terminating 10-16 weeks of gestation [oral group (76 ± 52) ml versus vaginal group (76 ± 61) ml, P=0.507]. The reoccurrence of menstruation was about 37 days in both oral and vaginal groups. Two cases of incomplete abortion were serious adverse events (SAE) relating to treatment. The common adverse events (AE) of nausea and vomiting were significantly higher in oral group [57.2% (239/417), 36.3% (151/417)] than those in vaginal group [45.4% (94/208), 26.1% (54/208); P=0.005, 0.011]. Conclusion Oral or vaginal misoprostol combined with mifepristone, is effective and safe for termination of pregnancy between 8 and 16 weeks of gestation.

OBJECTIVETo study the distribution of abdominal and pelvic lymph nodes involved in non-Hodgkin lymphoma in Chinese patients.

METHODSCT images of 241 non-Hodgkin lymphoma patients with abdominal and pelvic lymph nodes involved were reviewed. Of them, 96 patients whose clinical and image data fulfilled the requirements of the analysis were included: 1. Positive abdominal and/or pelvic nodular lesion in untreated patients examined by CT (n = 74). 2. New lesions in abdominal or pelvic lymph nodes who never had any nodular lesion by previous abdominal and/or pelvic CT (n = 14). 3. Treated patients who did not have abdominal and/or pelvic CT before, showed regression of initial disease for at lease 6 months after chemotherapy and patients showing abdominal and/or pelvic nodal lesions (n = 8) were assessed. In accordance with Clinical Schema for the Lymphoid System, these patients were divided into 3 histology subtypes: indolent (IL; n = 31), aggressive (AL; n = 61) and very aggressive (VAL; n = 2) lymphoma. The remaining 2 cases were unclassified (UCL). Both abdominal and pelvic CT scans were undertaken in 46 patients, abdominal CT only in 47 patients and pelvic CT only in 3 patients. Enhanced CT with i.v. contrast was obtained in 80 patients. The anatomic sites involved were designated as retroperitoneal (i.e. paraaortic), mesenteric, abdominal (i.e. celiac, paracardiac, gastrohepatic, and hepatic hilar, etc), retrocrural, subdiaphragmatic, common iliac, internal iliac, external iliac, and inguinal nodes, respectively.

RESULTSThe lesions were located in the retroperitoneum, with an incidence of 83% for both IL and AL. These were predominantly seen superior and inferior to the renal hila, with incidences of 72.0% (18/25) in IL and 67.3% (33/49) in AL. Pelvic lymph nodes came the next, with incidences of 41.9% (126/301 sites of IL and AL), 57.5% (50/87 sites) in IL and 35.5% (76/214 sites) in AL. Mesenteric lymph nodes stood third with incidences of 37.1% (33/89 IL and AL), 43.3% (13/30) in IL and 33.9% (20/59) in AL. There was only one statistically significant evidence that the external iliac lymph nodes were much more commonly seen in IL than in AL (P < 0.05).

CONCLUSIONIn Chinese patients, retroperitoneal, iliac, and mesenteric nodes are the most commonly involved lymph nodes in NHL. The involved retroperitoneal lymph nodes are predominantly located superior and inferior to the renal hila. The anatomic distribution of abdominal and pelvic lymph nodes in NHL of Chinese patients is different from that of the western countries.

Abdomen ; Adolescent ; Adult ; Aged ; Asian Continental Ancestry Group ; Child ; China ; epidemiology ; Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Lymphoma, Non-Hodgkin ; epidemiology ; pathology ; Male ; Middle Aged ; Pelvis

OBJECTIVETo monitor the incidence change of acute coronary heart events in the all-ages farmers in Panyu District, Guangzhou City during 1991-2001 and 2010-2011.

METHODSThe surveillance on the same defined population as that from the PRC-USA cooperative epidemiologic project on the cardiovascular and pulmonary diseases 30-year ago was carried out in Panyu, Guangzhou in 1991-2001 and 2010-2011. The crude incidence of acute coronary events and the age-standardized incidence rate were calculated by the year, gender and age, and standardized with the world standard population age distribution. Incidences at the two different periods were compared. The annual average changing rate of the incidence was obtained by the regression analysis methods.

RESULTSIn the 11 consecutive years of 1991-2001, a upward trend on the incidence of acute coronary events among the farmers in women in Panyu District was found (P < 0.05). The incidence of the acute coronary events in the year of 2010-2011 was significantly higher than that in the year of 1991 to 2001 [34.06 per 100 000 (age-adjusted rate as 28.50 per 100 000) versus 16.14 per 100 000 (age-adjusted rate as 16.57 per 100 000), P < 0.05]. The age-adjusted rate increased by 83.04%. Peak incidence of acute coronary events in males was noticed in 75-79 age group, and in 80-84 age group in females. Comparing to the period of 1991-2001, the largest incidence increases appeared in the age groups of 35-39 and 75-79 years in males, while in the age groups of 50-54 and 65-69 years in females. Up to 47.37% (36/76) events occurred on the age group older than 75 years, raised by 40.44% comparing to that in 1991-2001 (33.73%, 56/166).

CONCLUSIONSThe incidence of acute coronary events among farmers in Panyu District is at middle or low level of China but there is an increasing trend in acute coronary incidence from 1991 to 2011. Our results suggest that the prevention and treatment on acute coronary syndrome should be strengthened, and especially on the age group with the largest increase of disease incidence.

Acute Disease ; Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Coronary Disease ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Rural Population ; Sentinel Surveillance