Objective To explore the mechanism of combined treatment with methotrexate (MTX) and Ga-Al-As laser irradiation for rheumatoid arthritis (RA) and to assess the effectiveness of Ga-Al-As laser therapy for RA. Methods Twenty-two patients with RA were randomly and evenly divided into two groups: the treatment group treated with Ga-Al-As laser irradiation combined with MTX and the control group treated with MTX only. Ten age-matched normal subjects were observed as normal controls. The amount of CD4 + CD25 + regulatory T cells in peripheral blood (PB) of the normal controls and that in the PB and synovial fluid (SF) of the 22 patients before and after therapy were counted by flow cytometry. Meanwhile, the amount of prostaglandin E2 (PGE2) in synovial fluid of the patients was measured before and after treatment by enzyme-linked immunosorbent assay(ELISA). Results After combined treatment the clinical symptoms of the patients were improved significantly, and the amount of PGE2in SF decreased significantly. The count of CD4 + CD25 + regulatory T cells in PB of RA patients was ( 3.84 ±3.20) % , compared to ( 10.05 ± 7.04) % in healthy individuals. The count of CD4 + CD25 + regulatory T cells in SF of RA patients was ( 14.89 ± 12.30) % , much higher than that in PB. The count of CD4 + CD25 + regulatory T cells in SF decreased significantly in treatment group compared to control group (P ＜0.05). Conclusion Ga-Al-As laser irradiation eombined with MTX can effectively improve the clinical symptoms of RA patients. It may be related to the decrease of amount of PGE2 and count of CD4 + CD25 + regulatory T cell in PB and SF.

Objective To investigate the value of contrast-enhanced ultrasonography(CEUS) for differential diagnosis of focal splenic solid lesions.Methods Thirty-two patients with 32 focal splenic lesions were examined with CEUS.The enhancement phases and perfusion were observed.Each group has 16 patients.Results The contrast media extincted more quickly in malignant lesions than in benign ones.The peak time and initial decreasing time of the malignant lesions were (19.7±4.5)s and (29.7±10.9)s.The opposite time of the benign lesions were (24.2±4.4)s and (50.9±22.8)s.The initial decreasing time of the malignant lesions was earlier than that of the benign ones.The enhancement pattern was similar between the two groups.More lesions can be detected after CEUS.The number of the lesions was 111 before CEUS and 142 after CEUS.Conclusions CEUS is useful in the differential diagnosis of splenic lesions.

Objective To investigate the diagnostic value of ultrasound in primary hepatic lymphoma (PHL).Methods The ultrasonic and clinical features in 40 cases of PHL were analyzed retrospectively.All cases were pathologically confirmed by surgical operation or ultrasound-guided biopsy.Results The most common presentation of PHL was a solitary lesion which occurred in 57.5％ (23/40) of patients,followed by multiple lesions in 30.0％ (12/40),and diffuse infiltration patterns in 12.5 ％ (5/40).The first two types were usually shown on ultrasound as hypoechoic lesions with surrounding normal liver parenchyma in 88.6％ (31/35) of cases.The diffuse pattern presented as diffuse hepatomegaly without nodules in the liver parenchyma.There were 52.5％ (21/40) of the lesions which could not be diagnosed either as benign or malignant by ultrasound.Conclusions The clinical presentations and imaging features of PHL are non-specific.PHL should be considered as a differential diagnosis in cases of liver metastases when no primary tumour is apparent,or when sonographic findings show atypical features of primary liver carcinoma or hemangioma.When patients with unexplained fever and diffuse hepatomegaly,PHL should be considered and precaution should be taken to prevent to misdiagnose these patients as having fatty liver or chronic liver disease.

Objective To investigate the relationship between ultrasound features and pathological types of primary hepatic lymphoma (PHL).Methods Ultrasound and pathological features in 26 cases of PHL were analyzed retrospectively.Results The most common presentation of PHL was a solitary lesion,which occurred in about 57.7％ (15/26) of cases,followed by multiple lesions in about 26.9％ (7/26) of patients,and least commonly as diffuse infiltration patterns in about 15.4％ (4/26) cases.The first two types were similar and usually demonstrated as hypoechoic lesions to the surrounding normal liver parenchyma in 86.4％ (19/22) of cases on ultrasound.All the cases were B-cell non-Hodgkin lymphoma proven by histological and immunohistochemical examinations.The diffuse pattern demonstrated diffuse hepatomegaly without nodular,which were T-cell non-Hodgkin lymphoma proven by histological and immunohistochemical examinations.Conclusions PHL could be divided into single,multiple and diffuse types on ultrasound.The single and multiple types mainly present as hypoechoic lesions and the diffuse type shows hepatomegaly on ultrasound,which are closely related to histology and T or B-cell phenotype on immunohistochemical examination.

0.05). Conclusions CEUS can accurately display the perfusion changes of CIRD model of dogs,it's more sensitive than the BUN and SCr. DPI and TTP are the most sensitive quantitative indexes of CEUS.

Objective To assess the value of ultrasonography(US)in the diagnosis of pancreas endocrine tumors(PET).Methods Thirty-six patients with PET confirmed by surgery and pathology were retrospectively reviewed.Results There were 37 PET in 36 patients,among which 33 tumors in 32 cases were detected bv US,four tumors were missed on US and the detection rate was 88.9%(32/36).The tumor size was 1.0 cm×0.8 cm～12.9 cm× 11.3 cm.Among 12 cases of equal to or less than 2 cm,9 tumors were detected and the detection rate was 75.0%.PET presented mostly hypoechogenicity(78.8%),other 7 cases presented mixed-echogenicity.Color Doppler US was performed on 12 cases and 11 tumors showed color blood signals.Abundant flow signal was detected in 8 tumors(66.7%).PET were found in pancreatic head (n=11),neck(n=2),body(n=6)and tail(n=11),which was diagnosed correctly in 30 cases (81.1%).Conclusions US is a useful tool in the detection and diagnosis of PET.

Objective To evaluate the contrast-enhanced ultrasonography (CEUS) in quantitative diagnosis of chronic renal insufficiency. Methods Correlation of CEUS indexes with glomerular filtration rate (GFR) detected by 99mTc-DTPA renography was examined. Thirty-three cases of clinical chronic renal insufficiency were enrolled in the study. They were 15 males and 18 females with average age of (43.33±6.78) years. After intravenous bolus injection of 1 ml SonoVue,CEUS of renal cortex blood perfusion was performed successfully, and a time-intensity curve (TIC)was created with PHILIPS iU22 system's QLAB software. A 148 to 222 MBq dose of 99mTc-DTPA was injected as a bolus from antecubital vein. Renal scintigraphic images were collected immediately and GFR was obtained. Results The significant correlation coefficients between GFR and CEUS quantitative indexes were as follows: rAUC (area under curve)=0.886 (P＜0.05), rA (slope rate of ascending curve, A) =0.804(P＜0.05). However, rDPI (derived peak intensity, DPI)=0.021 (P＞0.05), rTTP (time to peak, TTP) =0.043 (P＞0.05), rα (slope rate of descending curve,α)=0.039 (P＞0.05). Conclusion CEUS can precisely display the hemodynamic change of chronic renal insufficiency, which is well correlated with GFR by 99mTc-DTPA renography.

Objective To evaluate the value of contrast-enhanced ultrasonography (CEUS) in quantitative diagnosis of chronic kidney dysfunction(CKD) by comparing it with color Doppler imaging (CDFI). Methods Tirty-three cases (15 males and 18 females) of clinical confirmed CKD (stage Ⅲ～Ⅴ)were included. Forty-five healthy volunteers were performed as control group. CEUS and CDFI were performed on each patient. After intravenous bolus injection of 1ml SonoVue each side,CEUS of renal cortex blood perfusion was collected successively,and a time-intensity curve(TIC) was created with Philips iU22 system's QLAB software. Resistance index(RI) and peak systolic velocity(PSV) of renal partial arteries were also tested. Results Compared with normal kidney,CKD patients had delayed perfusion and decreased intensity. Changes of area under curve(AUC), derived peak intensity(DPI), slope rate of ascending curve(A)and time to peak(TTP) were statistically significant ( P ＜0. 05). Sensitivities of AUC,DPI,A and TTP in diagnosis of CKD (stage Ⅲ～Ⅴ ) were 91.2% ,84. 9% ,90.9% and 85.3%, their specificities were 95.4%,88.9% ,93.3% and 90.9%, their accuracies were 93.6%, 87. 2%, 92.3% and 88. 5%, respectively. The results of CEUS were better than RI in CDFI (sensitivity 70.4%, specificity 37. 8%, accuracy 52.2%).Conclusions CEUS can precisely display the hemodynamic change in CKD ( stage Ⅲ～Ⅴ ), and is more sensitive than CDFI.

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in preoperative classification for hilar cholangiocarcinoma. Methods Forty-six patients with 46 hilar cholangiocarcinoma were diagnosed by surgical pathology in Zhongshan Hospital of Fudan University from January 2007 to April 2013. The echogenicity difference on conventinal ultrasound and CEUS were compared with chi-square test. The accuracy of conventinal ultrasound and CEUS for evaluating invaded bile duct, detective rates for portal vein invasion and displaying rate of metastatic hilar lymph nodes were compared with chi-square test or Fisher’s Exact test according to the golden standard of operative exploration. Results On CEUS, 82.6%(38/46) and 91.3%(42/46) hilar cholangiocarcinoma were hypoechoic in portal vein phase and delayed phase respectively, while 63.0%(29/46) hilar cholangiocarcinoma were isoechoic on conventinal ultrasound with vague margin. The clearly displaying rates were 37.0%(17/46), 84.8%(39/46) and 91.3%(42/46) in conventinal ultrasound, portal vein and delayed phase of CEUS and the echogenicity was signiifcantly different. The evaluation accuracy of hilar cholangiocarcinoma invading bile duct was improved from 80.4%(37/46, conventinal ultrasound) to 100%(46/46, CEUS) significantly (χ2=7.882,P=0.005). Portal vein invasion were found in 9 cases during operative exploration and the detective rates on conventinal ultrasound and CEUS were 78%(7/9) and 89%(8/9) without signiifcant difference (P=1.000). Metastatic hilar lymph nodes were found in 8 cases and the displaying rates on conventinal ultrasound and CEUS were the same (75%, 6/8) without signiifcant difference (P=1.000). Conclusions CEUS could signiifcantly improve the clearly displaying rate of hilar cholangiocarcinoma and improve the evaluation accuracy for invaded bile duct comparing with conventinal ultrasound.

Objective To compare the differences of cardiac function and interstitial remodeling between diastolic heart failure(DHF) and systolic heart failure(SHF) rabbit models. Methods To establish DHF model with abdo-mial aorta constriction and SHF model with abdomial aorta constriction plus aortic insufficiency. The cardiac func-tion was examined by UCG parameters and homodynamic parameters. The collagen content was measured through hydroxyproline colorimetric assay and shown as collagen area(CA), collagen volume fraction(CVF) and area ratio of Ⅰ to Ⅲ type collagen with PSR. Results Compared with control group, there were significantly increased thick-ness and stiffness of myocardium, impaired diastolic function but normal ejection fraction (EF), and significantly increased collagen content, CA, CVF and area ratio of Ⅰ to Ⅲ type collagen in DHF group; heart chamber was sig-nificantly enlarged, systolic function decreased, and collagen content, CA, CVF significantly increased, but ratio of Ⅰ to Ⅲ type collagen decreased in SHF group(P <0.05 or P <0.01). Conclusion DHF and SHF rabbit mod-els were established successfully, which can simulate clinical profiles and provide technical support to future re-search.