Objective To study the causes of misdiagnosis between renal cell carcinoma (RCC) and renal angiomyolipoma (RAML). Methods Since 1990, 228 cases of RCC and 62 RAML were surgically treated.13 of them,4 RCC and 9 RAML were incorrectly treated because the misdiagnosis on imaging examination or intraoperative frozen section study. The causes were analyzed. Results 4 RCC underwent enucleation or simple nephrectomy because of the frozen section diagnosis of RAML.None have developed recurrent RCC with 1～4 years of follow up.Of the 9 RAML cases,6 have been misdiagnosed as RCC on imaging procedures.The other 3 patients that failed to reach a proper diagnosis on imaging examination were submitted to intraoperative frozen section studies.1 was diagnosed as RCC and the other 2 remained uncertain. Radical nephrectomy have been performed for 9 patients. Conclusions Difficult interpretation due to poor quality of frozen sections is a potential cause of diagnosis error.RCC might be confused with RAML when the specimens contained highly vascular tissue. The content and distribution of fat is the main cause of imaging misdiagnosis.

Objective To evaluate the efficacy of percutaneous vertebroplasty for treating the vertebral compression fractures and vertebral metastatic neoplasms, and to assess its clinical curative effects Methods Among 81 cases (47 men and 34 women; ages 35～84, mean age 61 2 years), 110 vertebrae with metastatic neoplasms (61 cases) or vertebral osteoporosis (20 cases) were infused with methacrylate guided by DSA Effect of the operations was observed closely after the procedures Results The procedures were successful in all the involved patients and no significant complications were noted clinically Among the 61 patients treated for malignancies, 58 showed marked pain relief and 3 moderate pain relief 20 patients with vertebral osteoporosis demonstrated complete pain relief The cement leakage observed on radiographs included slight leakage to the adjacent disc (6 of 110, 5 5%), the epidural fat (8 of 110, 7 3%), the perivertebral venous plexus (2 of 110, 1 8%), and the paravertebral soft tissues (2 of 110, 1 8%) Conclusion Percutaneous vertebroplasty can significantly relieve the pain in patients with osteoporotic fractures caused by the malignancies and the vertebral osteoporosis We suggest that slight PMM leaks, when not symptomatic, should not be considered as complications

Objective To assess the value of MRS in evaluating vertebral bone marrow. Methods A total of 152 female volunteers (mean age 58±14 years, ranged 30～80 years) were recruited in this study. All subjects underwent vertebral MRS examination after routine MRI examination (sagittal T_2WI, T_1WI and axial T_2WI). Single voxel (SV) was chosen for the 1H MRS acquisition at L_2～L_4 vertebral body with PRESS sequence. MRS parameters were measured by SAGE 7.0 software. Results The fat fraction (FF%) of vertebra ascend with aging;the water line width (LW) decrease with aging and there was not obvious tendency with lipid LW. Conclusion Vertebral MRS can be considered as a noninvasive examination added to routine spine MRI to demonstrate the changes of vertebral bone marrow.

Objective To investigate the effects of Xuebijing injection on the production of ICAM-1 and its counterreceptor(LFA-1)in ANP of rats at different time points.Methods ANP was induced by multiple points in- jection of 5% chenodeoxycholic acid into the pancreas,followed by ligation of pancreatic duct.Expressions of ICAM- 1 at different time points were assessed by immunohistochemistry method,the expressions of LAF-1 on neutrophils at different time points were detected by flow cytometer.The effect of Xuebijing injection was also evaluated by de- tecting the output of ascitic fluid,amylase level and histological changes in pancreas and lungs.Results The expres- sions of ICAM-1 in pancreas and lung of Xuebijing injection group decreased significantly than those in ANP group at most time points during the research period(P

Objective To investigate the expression of hepatocyte growth factor (HGF) and its receptor c-Met in colorectal cancer tissues and their clinical significances.Methods 100 patients with colorectal cancer who accepted treatment from March 2012 to 2015 February were collected.The immunohistochemical method was used to test the expression of HGF and c-Met in tumor tissues.The correlation of clinicopathological parameters and lymphatic microvessel density (LMVD) was analyzed.Results The positive expression rates of HGF in patients with or without lymph node metastasis were 100.0 ％ (35/35) and 41.5 ％ (27/65),the difference had statistical significance (x2 =6.99,P ＜ 0.05).The positive expression rates of c-Met were 94.3 ％ (33/35) and 47.7 ％ (31/65),the difference was statistically significant (x2 =7.75,P ＜ 0.05).The positive expression rates of HGF in patients with TNM stage Ⅰ + Ⅱ and Ⅲ + Ⅳ were 48.6 ％ (17/35) and 69.2 ％ (45/65),the difference had statistical significance (x2 =5.94,P ＜ 0.05).The positive expression rates of c-Met were 51.4 ％ (18/35) and 70.8 ％ (46/65),the difference was statistically significant (x2 =6.08,P ＜ 0.05).The LMVD of patients with different lymph node metastasis,tumor stage,HGF and its receptor c-Met expression were statistically different (t values were 10.19,10.08,7.50,5.07,all P ＜ 0.05).Conclusion HGF and its receptor c-Met is closely related to the development of colorectal cancer.They can help the diagnosis,and be used as new targets in the treatment of colorectal cancer.

Objective To study the expression of HIF-1α and survivin in gastric cancer,and to study their role in tumor angiogenesis,invasion and metastasis.Methods Immunohistochemieal technique was used to detect the expression of HIF-1α and survivin in 54 cases of gastric cancer.Results The expression rate of HIF-lα in gastric cancer (74.1%) was higher than that in normal gastric tissue (O),The expression of HIF-1α in gastric cancer was associated with TNM staging,invasive depth and lymph-node metastasis (P<0.05),The expression of survivin in gastric cancers was high (72.2%),and increased with invasive depth (P<0.01),clinical stages (P<0.01) and lymphatic metastasis (P<0.05).There was a positive correlation between expression of HIF-1α and Survivin (r:0.31,P<0.05).Conclusion HIF-1α and Survivin could be factors in the judgement of the degree of malignancy of gastric cancer and prediction of its prognosis.

Objective To analyze the cause of missing diagnosis for vertebral fracture on lateral chest radiography. Methods Lateral chest radiographies of 1638 hospitalized patients (871 males and 767 females) were retrospectively reviewed for identifying vertebral fractures. Their ages ranged from 50 to 91 years with the mean of 63.5 years. Complains and application for chest radiography in all patients were not related to osteoporosis and vertebral fracture. Vertebral fracture and fracture severity were evaluated using Genant's semiquantitative visual method, taking approximately a 20%-25% vertebral height reduction as mild grade,26%-40% as moderate grade and 41% or greater as severe grade. Evaluation results of the vertebral fracture, original X-ray reports, as well as medical records were compared for further analysis. Results Eighty-four in 1638 patients showed vertebral fractures on the lateral chest radiographies. Of them,vertebral fractures were reported in 30 cases and 54 patients were not reported on their original X-ray reports. There were 63 vertebral fractures in 54 un-reported patients, most of which were single fracture (75% or 47/63). Grade Ⅰ fracture accounted for 54% (34/63), Grade Ⅱ fracture 33% (21/63), while 13% presented grade Ⅲ fracture (8/63). In all 84 patients with vertebral fractures, only 5 cases (6%)underwent dual energy X-ray absorptiometry (DXA) measurement, 5 cases ( 6% ) were recorded to have vertebral fractures on the medical papers, as well as 15 cases ( 18% ) were prescribed drugs related to the osteoporosis when discharged from hospital All drugs prescribed for the 15 patients were limited only to calcium. Conclusions More attention should be paid to osteoporosis by doctors including radiologists.Vertebral fracture on lateral chest radiography should be completely diagnosed, which is helpful for both prevention and treatment.

Objective To describe the clinical and imaging manifestations of patients with synovitis acne pustulosis hyperostosis osteomyelitis (SAPHO) syndrome,and to analyze the diagnostic importance of different clinical and imaging manifestations for SAPHO syndrome. Methods Seventeen patients (7 males and 10 females) with SAPHO syndrome were recruited in this study.Age ranged from 36 to 67 years with a mean age of (48 ± 8) years. All patients fulfilled the diagnostic criteria of Benhamou. Serum HLA B27 antigen records were reviewed for all patients. Imaging data of the abnormal bone sites were collected by conventional radiograph in all patients,CT in 13 patients as well as MR in 3 patients.Average time to take for a definite diagnosis of the syndrome was 3.7 years (ranged from O.5 to 13 years).Results Serum HLA B27 antigen was positive in all patients. Both skin and bone abnornalities were found in all patients.Ten patients had skin palmoplantar pustulosis and two patients had acne. Involving sites of bone and joints include sacroiliac joints,anterior chest and limbs.Sacroiliac joints were asymmetrically involved with imaging features in all patients.Eight patients exhibited anterior chest wall involvement. Five patients had osteomyelitis at limbs. For all images of 17 patients,CT was superior to conventional radiography in detecting abnormal changes of bone erosion and soft tissue swelling.MR imaging was able to depict edema changes that was not detectable by CT and radiography.Conclusion SAPHO syndrome is a rare disease,but for patients with skin and bone-joint abnormalities,especially with skin palmoplantar pustulosis,acne as well as with imaging features at the sacroiliac joint and anterior chest wall,SAPHO syndrome should be taken into a diagnostic consideration.

Cardia ; pathology ; surgery ; China ; epidemiology ; Esophageal Neoplasms ; diagnosis ; epidemiology ; surgery ; Esophagectomy ; Esophagoscopy ; Gastroscopy ; Humans ; Mass Screening ; Minimally Invasive Surgical Procedures ; Precancerous Conditions ; diagnosis ; surgery ; Stomach Neoplasms ; diagnosis ; epidemiology ; surgery

ObjectiveTo analysis the clinical efficacy of using lateral homodigital flaps based on digital artery perforator to repair the fingertip defects. MethodsFrom October 2008 to August 2010,nine patients with twelve fingertip defects,including 5 thumbs,2 index fingers,3 middle fingers,2 ring fingers,underwent repair with lateral homodigital flaps based on digital artery perforator.The size of the flaps ranged from 2.7 cm× 1.4 cm to 3.1 cm× 1.8 cm.The donor site were covered by skin graft. ResultsEleven flaps survived.One case met with partial necrosis.The follow-up time ranged from 3 to 6 months(average of 4.5 months).The finges had good appearance.Ten cases had gained full postoperative sensory recovery and the two-point discrimination was 4-Smm at 3 months after operation.ConclusionUsing the flaps pedicled with digital artery perforator is a feasible solution for treatment of fingertip defects.