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 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.

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 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.

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 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 assess which of topical tacrolimus and topical highly potent steroids,is more effective and safer in the treatment of pediatric vitiligo.Methods The PubMed,Cochrane library,Scopus and CINAHL plus databases were retrieved.The search was confined to English language articles.The randomized controlled trial(RCT) articles were included in our study.The quality of the identified articles was examined by using the CASP Randomised Controlled Trials Checklist.Results As a result,there were only a few studies related to the comparison.However,there were only two RCTs regarding a comparison of topical tacrolimus 0.1％ and clobetasol propionate 0.05 ％ in childhood vitiligo.Conclusion When the body surface area (BSA) involved in the child is ＜20 ％,and the disease is not rapidly spreading,topical therapy is the first choice.Topical tacrolimus may be considered as an alternative therapy for childhood vitiligo,especially for acrofacial and segmental types,before considering other modalities,but still need to observe long-term side effects.

Objective To investigate the value of contrast enhanced ultrasonography ( CEUS) in the diagnosis of hepatic epithelioid hemangioendothelioma( HEHE) . Methods The images of CEUS had been retrospectively evaluated in 21 lesions of HEHE which were confirmed by pathology . The perfusion patterns and time of enhancement were observed ,including time to begin enhancement , time to peak enhancement ,the washout time and the appearance of internal structures . Results The mean time of begin enhancement ,time to peak ,time to isoechogenity and hypoechogenity were ( 17 .4 ± 5 .2) s ,( 22 .0 ± 7 .2) s , ( 23 .9 ± 4 .6 ) s and ( 42 .2 ± 13 .7 ) s ,respectively . During the arterial phase , 8 lesions showed diffuse enhancement ,7 lesions showed rim-like enhancement and 6 lesions showed branch enhancement . The inner margin in 6 lesions showed speculate enhancement . The central portion of the tumors was not enhanced in part lesions of 8 cases . As to time of peak enhancement ,compared to the normal hepatic parenchyma , hypoenhancement ,isoenhancement and hyperenhancement were observed in 10 lesions ,6 lesions and 5 lesions respectively . Synchronous enhancement was observed in 11 lesions on CEUS ,rapid enhancement was observed in 8 lesions and slow enhancement was observed in 2 lesions . Twenty-one lesions manifested hypoechoic mass in portal phase and delayed phase . The boundary of lesions was unclear on conventional ultrasound and became distinct after contrast injection in 21 lesions . Conclusions CEUS is useful for the diagnosis of HEHE .

Objective To investigate the positive ratio of urine and gender difference of chronic kidney disease(CKD) with children in Lanzhou,a heavy pollution and underdeveloped city in northwest of China.Methods Through the Multistix 10 SG,the morning urine of the children were detected,which aged from 12 to 13 years old.Results The positive ratio of urine was 14.9％ in subjects,18.2％ in girls and 12.8 ％ in boys respectively.Furthermore,the positive ratio in girls showed statistically significant higher than boy's.(x2 =21.77,P ＜ 0.01).Espcially,the ratios of hematuria and pyuria significantly increased in girls (x2 =17.52,P ＜ 0.01;x2=7.95,P ＜ 0.01).Conclusion The gender difference of the positive rate of urine was existed in our large samples.And there is a higher prositive rate of hematuria and pyuria in the girls.This investigation will enrich the epidemiological data of CKD in children(12 ～ 13 years old)in Lanzhou city.