Clinical symptoms,multi screeming characters and pathological features of 15 cases of FNH were analysed retrospectively.11 cases were treated by operation.The results showed that three quarters(12/15) of the patients were male.Only one third(5/15) of the patients were diagnosed as FNH according to multi screeming of B US,CT and MRI.There were no complications for the 11 cases after operation.The results indicated it is difficult to diagnose FNH only by multi screeming methods.Operation is the best option for the treatment of FNH.

ObjectiveTo evaluate the early image alterations of primary liver cancer (PLC) treated by high intensity focused ultrasound (HIFU). MethodsA total of 55 PLC patients underwent extracorporeal HIFU ablation. Color Doppler ultrasound, digital substraction angiography (DSA), computed tomography (CT) or magnetic resonance imaging (MRI) were performed to monitor the therapeutic response.ResultsImage examinations obtained 2 weeks after HIFU ablation showed significant response of PLC. MRI was the best for evaluating HIFU efficacy. Unenhanced MRI revealed signal alterations on both T 1 and T 2 weighted images, and enhanced MRI demonstrated the absence of contrast enhancement in the treated HCC and a thin peripheral rim of enhancement surrounding the coagulation necrosis. ConclusionMRI rapidly assesses HIFU induced complete ablation of HCC, residual viable cancer tissure in treated region, and coagulation extent of HIFU treatment.

Objective To summarize the experience in diagnosis and treatment for solid-pseudopapillary tumors of the pancreas (SPT). Methods A retrospective clinical analysis about clinical, imaging and pathologic data was made on 16 cases of SPT admitted from January 2005 to December 2009. Results Five had SPT in the head of the pancreas, 5 in the body of the pancreas, 6 in the tail of the pancreas. The first symptom was intermittent epigastric pain ( n = 7), abdominal aponia mass ( n = 3), Pancreatic tumor found by chance (n =4), weight loss (n =2). Solid and Solid-cystic masses of low echo were found in US. Masses of low density in pancreas were found on CT scan, while irregular enhancement appeared in the circumference of all tumors in enhanced CT scan sequences. Tumor markers in patients' erum were all negative.9 patients underwent distal pancreatectomy and spleen resection, including 1 patient also underwent left hemicolectomy. Local excision of tumor was performed in 4 cases. Pancreatic local excision and pancreaticojejunostomy were performed in 3 cases. 14 cases were followed up with an period of from 3 to 48 months. No evidence of relapses and metastasis in these cases was found. Conclusion SPT primarily affects young women, and it may be located in any part of pancreas. Surgical resection is recommended as the treatment of choice. The prognosis is good.

The goal of the study was to investigate the protective effect and mechanism of Artemisia argyi ethanol extract on chemotherapeutic vancomycin (VAN)-induced acute kidney injury (AKI).The acute kidney injury model of male ICR mice was induced by intraperitoneal injection (ip) of VAN.Thirty mice were divided into the blank group, model group, high dose group, middle dose group and low dose group, which were given medicine by gastric perfusion (ig).Serum levels of cystain C (Cys C), blood urea nitrogen (BUN) and serum creatinine (Scr) were measured, which could reflect renal function of mice.Serum oxidative stress and inflammation indices were also determined, including muscular dystrophy association (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), tumor necrosis factor-alpha (TNF-α), Interleukin-1β (IL-1β), and high-sensitive c-reactive protein (hs-CRP).In addition, hematoxylin-eosin staining (HE) was employed for measuring the damage of renal tissues and the content of apoptosis b-cell lymphoma-2 (Bcl-2), Bcl-2 assaciated X protein (Bax) and caspase-3 were measured too.All results showed that Artemisia argyi extract exhibits protective effect on chemotherapeutic VAN-induced AKI, whose mechanism could be related to the oxidative stress, inflammatory reaction and apoptosis.

Objective To asses the value of ST segment elevation of aVR lead (aVRSTE) in patients with acute ST segment elevation myocardial infarction (STEMI). Method Myocardial enzymes detection, electrocar-dingraphy, emergency eornary artery angiography, echoeardiography [taken(10±2) days after emergency cornary artery angiography] were obtained and analyzed in 140 consecutive patients with STEMI enrolled in this study. The value of aVRSTE (≥0.05 mV) was assessed for detecting left main stem lesions(defined as ≥50% stenosis of or acute embolism of left main stem)or its equivalent (defined as total or subtotal acute occlusion of left anterior de-scending artery), and predicting the left ventricular systolic function after myocardial infarction. Results The sensitivity, specificity, positive predictive value and negative predictive value of aVRSIE in detection of left main stem lesions were 72.73 % (8/11), 83.72 % (108/129),27.59 % (8/29) and 97.30% (108/111), respectively; in detection of left main stem lesions or its equivalent, they were 41.86 % (18/43), 88.66% (86/97), 62.07 % (18/29), 77.48% (86/111); aVRSYE were combined with STaVR-STv1>0 to detect left main stem lesions, the semi-tivity, specificity, positive predictive value and negative predictive value were 63.64% (7/11),98.45%(127/129),77.78%(7/9),96.95% (127/131). Patients were divided into two groups: groups A with aVRSIE and group B without aVRSYE. KIIJJP class,and left ventricular ejection fraction (LVEF) in group A was higher than those in group B (P<0.05). Conclusions For patients with STEMI: (1) aVRSTE indicated left main stem le-sions or its equivalent; if combined with STaVR-STv1>0, it indicated left main stem lesions more strongly; (2)aVRSTE predicted poorer left ventricular systohc function short time after STEMI.

Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of tuberculous mesenteric lymphadenitis by analyzing its enhancement pattern. Methods The conventional ultrasound and contrast-enhanced ultrasound images of 62 patients with tuberculous mesenteric lymphadenitis confirmed by needle core biopsy or surgery were retrospectively analyzed. The location, size, shape, internal echo and posterior enhancement of mesenteric lymph nodes were recorded. All cases were divided into two groups:the maximum diameter of the lymph node≤20 mm and the maximum diameter of the lymph node >20 mm, and the patterns of enhancement in two groups were analyzed. Results The conventional ultrasound of 62 cases with tuberculous mesenteric lymph nodes showed enlargement. And the echogenicity was hypoechoic or heterogeneity, containing punctate or clusters of calcification in 19 cases (30.6%). After CEUS, there were three forms of enhancements:rim enhancement in 29 cases (46.8%);inhomogeneous enhancement in 21cases (33.9%);non-enhancement in 12 cases (19.3%). Rim enhancement was more common in the≤20 mm group, while inhomogeneous enhancement was more common in the lymph nodes>20 mm. There was statistically significant difference of the enhancement type between the≤20 mm group and the>20 mm group (χ2=6.782, P=0.034). Conclusions Most of tuberculous mesenteric lymph nodes showed rim and inhomogeneous enhancement in CEUS, and the sizes of mesenteric lymph node tuberculosis influenced the CEUS enhancement patterns. CEUS may provide useful information for the diagnosis of the tuberculous mesenteric lymph node.

Objective:To develop a novel posterior circulation score (PCS) based on pretreatment diffusion-weighted imaging (DWI) for predicting futile recanalization (FR) of acute basilar artery occlusion (BAO) after endovascular therapy (EVT).Methods:A prospectively registered consecutive cohort of BAO patients treated with EVT in Beijing Tiantan Hospital, Capital Medical University during a six-year period was reviewed. This novel DWI-based PCS (DWI-PCS) was calculated according to the characteristics of acute infarction at four sites (pons, midbrain, thalamus and cerebellum), with a normal score of 0 point and a full score of 16 points. FR was defined as the occurrence of poor outcome (modified Rankin Scale score>3) at 90 days despite successful recanalization (modified Thrombolysis In Cerebral Infarction ≥ 2b) at final angiogram after EVT. The independent association of DWI-PCS with FR was evaluated by multivariable Logistic regression, and the predictive discrimination of DWI-PCS was measured by the area under the receiver operating characteristic (ROC) curve. Additionally, the effects of DWI-PCS on FR in different subgroups stratified by age, time window, stroke severity and etiology were explored.Results:Of 109 patients in this study, 48 (44.0%) suffered from FR. The multivariable Logistic analysis showed that DWI-PCS was significantly associated with FR (adjusted OR=1.31, 95% CI 1.07-1.62, P=0.01). The ROC curve analysis demonstrated that the area under the curve of DWI-PCS for predicting FR was 0.74 (95% CI 0.65-0.83), and the optimal cut-off value was ≥ 3 points (sensitivity 0.75, specificity 0.66, accuracy 0.70). Finally, the effects of DWI-PCS on FR were not found to be different across all subgroups ( P>0.10 for all interactions). Conclusions:The novel DWI-PCS may be a valid and reliable predictor of FR in BAO patients treated with EVT. Nevertheless, external validation with blinded outcome is still needed to confirm its performance before clinical application.

Objective To summarize experiences associated with hepatectomy of huge liver neoplasm.Methods Two hundred and sixty six consecutive cases of huge liver neoplasm undergoing hepatectomy from January 1987 to December 2005 at Chinese PLA General Hospital were analized retrospectively based on the clinical data.Results There were 174 males and 92 females with the average age of(44.8 ± 12.2)years(range 7-76 yrs).Among them,93 cases were with benign neoplasms.The maximum diameter of tumors was 30 cm and hemangioma accounted for 86.0%(80 cases).The other 173 cases were huge liver malignant neoplasms with the maximum diameter of 33 cm,hepatocellular carcinoma accounted for 73.4%(127 cases).The average diameter of all tumors was(14.7 ±4.0)cm(range 10.2-33.0 cm).HBsAg(+)was found in 40.49% of cases.Numbers of resected segments averaged(3.3 ±1.2)in benign cases and(3.1 ±1.2)in malignant ones without significant difference between the two groups(t=1.710,P=0.310).Postoperative complications occurred in 17.29% of cases and the hospital mortality was 0.75%.The postoperative 1-,3-and 5-year survival rates in patients with malignant liver tumors were 58.3%,39.7% and 27.5%,respectively.Conclusions Hepatectomy of huge liver benign and malignant neoplasms can be performed safely with low morbidity and mortality,provided that it is carried out with skillful surgical expertise and optimized perioperative management.

Objective To summarize the experience in surgical treatment of hepatic cavernous hemangioma (HCH). Methods The clinical data of 345 patients who received HCH resection in General Hospital of PLA from 1986 to 2005 were retrospectively analyzed. Results The ratio between male and female patients was 1/1.8. Eighteen patients (5.2%) were incidentally found with HCH during or after operation. Most of the HCH were located in the right lobe, with the proportion of 16.2% (56/345). Ninety-one patients (26.5%) had small HCH (diameter<5.0 cm), 173 (50.3%) had large HCH (diameter ranging from 5.0-10.0 cm), and 80 (23.2%) had giant HCH (diameter>10.0 cm). The mean diameter of the HCH was (8.0±5.0) cm. Three hundred and twenty-three (99.7%) patients were with Child pugh A. Right subcostal incision and enucleation were performed on all patients. The incidence of postoperative complications and mortality were 11.3% (39/345) and 0.3% (1/345), respectively. Caudate lobe resection was performed on 9 of 11 patients with the tumor located in caudate lobe. Conclusions Some HCHs may be easy to be misdiagnosed as hepatic solid tumor. HCH resection (inclu-ding hepatic caudate lobectomy) is safe for patients with HCH, and the most severe operative complication is massive bleeding during hepatectomy.

Objective To assess the surgical treatment of iatrogenic biliary strictures. Methods The clinical data of 235 patients with iatrogenic biliary injuries and strictures who had been admitted to our hospital from January 1989 to December 2006 were reviewed retrospectively. Cholangio-jejunal Roux-en-Y anastomosis (n=182), surgical repair with pediele flap of autogenous tissues (n=34), end-to-end choledocho-choledo-chostomy (n= 12), common bile duct incision and figuration +T-tube drainage ( n =6) and liver transplanta-tion ( n = 1 ) were applied to the patients. Results A total of 189 patients were followed up for 1 to 10 years. The total excellent and good rate was 94.7% (179/189). The recurrence rate of the biliary stricture was 5.3% (10/189), and the main cause of which were biliary cirrhosis, selerosing cholangitis and calculus. One patient with severe biliary cirrhosis and portal hypertension died of liver failure postoperatively. Conclusions The cholangio-jejunal Roux-en-Y anastomosis is a reliable and effective method. Surgical repair of the bile duet with pedicle flap of autogenous tissues could preserve the function of the sphincter of Oddi, but the long-term effect needs further investigation. Biliary stent is not usually necessary to install. Liver transplantation is efficient for the patients with end stage of biliary diseases caused by biliary stricture.