Objective To compare the diagnostic value of dual-phase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for localizing ectopic parathyroid lesions in patients with HPT secondary to chronic renal failure (CRF-HPT).Methods Medical records of 368 CRF-HPT patients (204 males,164 females,age range:12-76 years) from January 2011 to April 2015 were retrospectively analyzed.Pathological results was used as the gold standard for the diagnosis of HPT.The sensitivity and specificity of dualphase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for the diagnosis and localization of ectopic parathyroid lesions were studied and compared by x2 test.Results A total of 1 398 positive lesions were found in 356 patients by dual-phase 99Tcm-MIBI scintigraphy,and 54 ectopic lesions occupying 3.9％(54/1 398) of positive lesions were detected by delayed planar imaging or SPECT/CT fusion imaging in 45 patients.Most of them (n =53) were confirmed by pathology.While only 966 positive lesions were found in 254 patients and no ectopic lesions were identified by color Doppler ultrasonography.The diagnostic sensitivity and specificity of dual-phase 99Tcm-MIBI scintigraphy for CRF-HPT lesions were 97.2％(1 375/1 415) and 53.1％(26/49),respectively.The corresponding parameters of color Doppler ultrasonography were 66.4％ (940/1 415) and 46.9％ (23/49),respectively.The specificity of ectopic lesion localization by radionuclide imaging was 98.1％ (53/54).The accuracy of dual-phase 99Tcm-MIBI scintigraphy was significantly higher than that of color Doppler ultrasound in lesion localization (x2 =20.8,P ＜ 0.05).Conclusion Compared to color Doppler ultrasonography,99Tcm-MIBI scintigraphy is more sensitive in identifying the positive lesions and more specific in localizing the ectopic parathyroid lesions in patients with CRF-HPT.

Objectives To assess the clinical value of ultrasonography (US) and bioelectrical impedance analysis (BIA) in analyzing abdominal fat contents of obese children and adolescents through comparison with MRI. A correlation with other obese related metabolic parameters was conducted. Methods Ninety 7-17-y-old obese children and adolescents (60 boys and 30 girls with mean age of 9.6 ± 2.9 y and mean BMI of 24.5 ± 4.5 kg/m2) were recruited. Metabolic parameters were measured, and insulin resistance was estimated according to homeostasis model assess-ment (HOMA-IR). On the same day abdomen subcutaneous fat thickness (SFTUS) was measured by US. Body fat mass (FMBIA) and abdominal visceral fat area (VFABIA) were analyzed by bioelectrical impedance analysis (BIA). After obtaining informed consent, abdominal MRI was performed in 20 subjects. Each section of umbilicus level was analyzed by image threshold value segmentation using SigmaScan Pro 5 and abdominal subcutaneous fat area (SFAMRI) and visceral fat area (VFAMRI) were calculated. Results (1) A strong positive association was found between SFTUS and SFAMRI (P< 0.05), VFABIA and VFAMRI (P < 0.01) respectively. (2) FMBIA and SFAMRI, VFAMRI, SFTUS also showed significant correlations (P < 0.05). (3) VFAMRI showed extremely significant positive correlations with TG, Insulin,C-peptide and HOMA-IR (P < 0.01 ) ; SFAMRI was also correlated positively with them (P < 0.05). (4) SFTUS was correlated positively with UA (uric acid), Insulin, 2HIns (insulin measured at 2 hours after meal), C-peptide,2HC-peptide (C-peptide measured at 2 hours after meal) and HOMA-IR (P < 0.01). (5) VFABIA was correlated significant positively with UA, insulin, TG, 2HIns and HOMA-IR. FMBIA showed positive correlation with UA, Insulin,2HIns, C-peptide, 2HC-peptide and HOMA-IR. Conclusions abdominal subcutaneous and visceral fat of obese children and adolescents evaluated by US and BIA are correlated well with those assessed by MRI, and also correlated well with TG, insulin, C-peptide and other metabolic biochemical parameters. Our data support the value of using cost effective, simple and convenient methods such as BIA and US to evaluate the obese and related metabolic risk of children and adolescents in clinical practice.

Purpose To evaluate the feasibility of magnetic resonance T2 values in diagnosing hepatic fibrosis (HF).Materials and M1etdheds The models of HF were induced in rats by repetitive dosing of carbon tetrachloride.The stage of hepatic fibrosis (S),grade of inflammation (G) and degree of fatty liver (F) for the HF model animals and their normal controls were evaluated by pathology.The relationship between T2 values and liver fibrosis was analyzed by using multiple echo gradient spin echo sequences.Results According to the stage of hepatic fibrosis,the HF model rats were staged into S1-S4.The grade of inflammation of the HF model rats was G0 or G1,and the degree of fatty liver was F3 or F4,both of which had no statistical differences among the HF model rats at different fibrosis stages (P＞0.05).The T2 values for all rats including normal control rats in the stage of liver fibrosis from S0 to S4 were (38.27±1.45) ms,(42.08±2.63) ms,(45.93±3.61) ms,(50.23 ± 2.23) ms and (57.79± 5.40) ms,respectively,with a significant difference (F=31.903,P＜0.01).Except the T2 values had no significant difference between the S0 and S 1 stages (P＞0.05),the pairwise comparisons of the T2 values between the rest stages were statistically significant (P＜0.01).The T2 values were positively correlated with the stages of hepatic fibrosis (rs=0.921,P＜0.01).Conclusion The T2 value can quantitatively reflect the degree of hepatic fibrosis.

Objective To report the diagnosis and treatment of the pregnant women, who were positive for syphilis in serological test, as well as their final pregnant results. Methods we conducted a retrospective analysis of the serological test results of 3 105 pregnant women subjected to childbirth or induced labor in the department of gynaecology and obstetrics at our hospital since January of 2004. Results Of the 3105 pregnant women, 21 (6.76 ) were positive for treponema pallidum (TP). Additionally, 7 (33.33%) cases were positive for TRUST, and 6 (28.57%) negative. Only 2 cases showed skin lesion, canker and soft chancre. Of the 18 cases, who were found to get infection during pregnancy, 11 (61.11%) had taken the treatment against syphilis. Of the 21 women positive for TP, 5 were subjected to induced labor, 13 to cesarean section, and 3 to spontaneous parturition. The average time of pregnancy was (267.44?11.00) d. The Apgar score of all 16 newborns was 10 at birth. The umbilical blood of 5 infants was tested by TP and TRUST, among which 3 were positive by TP, 2 were positive for TRUST. All infants did not have any clinical manifestation of congenital syphilis after birth. There were 5 cases transferred to the ward of pediatrics, among which 2 undertook the treatment against syphilis, 2 against premature delivery, and 1 against asphyxia, and finally all had been cured. Conclusion The patients, who were found positive for TP during the early and middle period of pregnancy, can obtain a fine pregnant result, if undertaking regular examination and treatment against syphilis.

Objective To investigate the regulation of IFN-γ to Th17 response in Chlamydia muridarum (Cm) lung infection in mice. Methods A murine model of pneumonia induced by intranasal inoculation of Cm was used for this study. Anti-mouse IFN-γ McAbs were used to neutralize endogenous IFN-γfollowing Cm lung infection. Control group received the same dose of isotype antibody (IgG2a). Mice were sacrificed at day 7 postinfection. Chlamydial growth in the lung was assessed by immunoenzyme technique.IL-17 and IL-23 mRNA expression in the lung was assayed by RT-PCR and the proliferation of IL-17 + CD4 +T cells in the spleen was assayed by intracellular cytokine staining. Results IFN-γ-neutralized mice exhibited serious disease course, include greater body weight loss, higher organism growth and much more severe pathological changes in the lung compared with control mice. The mRNA expression of IL-17 and IL-23 in the lung and the proliferation of IL-17 + CD4 + T cells in the spleen significantly decreased in the IL-17- neutralized mice. Conclusion IFN-γ was protective in Cm lung infection through up-regulating the antigen specific Th17 responses.

Objective To explore the incidence and significance of intra-and extraosseous edema accompanying benign tumors and tumor like diseases.Methods Imaging studies including MR,CT and plain radiograph were retrospectively reviewed in 245 cases of benign osseous tumors and tumor like diseases proved by pathology(borderline tumor,cases associated with pathological fractures,cases with lesions of skull were excluded from the study).The incidence of bone marrow and soft tissue edema were defined on T2WI with fat suppression on MRI in all the cases.x2 test was performed for the incidence rate of edema in the benign tumors and tumor like diseases.The pre-operative diagnoses were reviewed,and the influence of edema to the differential diagnosis between the benign and malignant was analyzed.Results The total incidence of bone marrow and soft tissue edema associated with benign tumors and tumor like diseases was 37.1％ (91/245),which included Langerhans cell histiocytosis 85.2％ (23/27),osteoblastoma85.0％ (17/20),osteoid osteoma93.6％ (29/31),ehondroblastoma 87.0％ (20/23).There was no statistically significant difference of edema incidence among the above-mentioned four diseases.(x2=6.35,P＞ 0.05).Both cases of endosteal capillary hemangioma had edema around.No edema was found around the lesions of other kinds of diseases.41 of 91 cases (45.1％) with edema were misdiagnosed as malignant tumor by MRI pre-operatively.Conclusion The marrow and soft tissue edema is a common sign in the benign bone tumor and tumor-like diseases,and it is frequently seen in Langerhans cell histiocytosis,osteoblastoma,osteoid osteoma,chondroblastoma.

Objective To explore the changes of mTOR signaling in LPS/D-gal-induced acute hepatitis in mice . Methods Twenty-six healthy adult female ICR mice were divided into two groups:the control group and experimental group, 13 mice in each group .LPS/D-gal was used to induce acute hepatitis in the mice .The survival of mice was moni-tored within 24 hours after LPS/D-gal challenge .At 6 hours after challenge , samples of serum and liver tissue were collect-ed for further analysis.Results Injection of LPS/D-gal resulted in acute death of the mice within 24 hours.At 6 hours post LPS/D-gal injection , the blood levels of ALT and AST were significantly increased .The mRNA expression of inflammatory cytokines Tnfa and Il6 was up-regulated in LPS/D-gal-induced hapatitis , in which DNA fragmentation and activation of caspase-3 were subsequently observed .Immunoblot analysis showed that both mTOR pathway and NF-κB pathway were ac-tivated.Unexpectedly , inhibition of mTOR signaling could neither decrease the apoptosis in the liver nor increase the sur -vival of mice .Conclusions The results of the present study indicate that mTOR signaling may play pleiotropic roles in the pathogenesis of LPS/D-gal-induced hepatitis .

Objective To investigate the application value of functional exercise pathway in enhanced recovery of patients undergoing hepatectomy.Methods Fifty primary hepatic carcinoma patients who had undergone liver resection in Anhui Province Hospital from December 2014 to August 2015 were randomly divided into experimental group (n =25) and control group (n =25).Postoperative length of hospital stay,hospitalization charges,complications,postoperative pain score,postoperative ambulation and intestinal ventilation time were compared between these groups.Measurement data with normal distribution were represented as ((x) ± s) and comprison between groups was analyzed using the t test.Comparisons of count data were analyzed by the x2 test.Results Postoperative length of hospital stay of the experimental group [(7.00 ± 2.27) days] were shorter than control group [(9.36 ± 4.58) days] (t =3.090,P =0.003),and hospitalization expense was lower in the experimental group [(28 184.57 ± 8 675.65) yuan] (t =2.281,P =0.025).Compared with control group (40％),the experimental group (20％) had lower overall complication incidence (t =4.286,P =4.286),and general complications incidence (8％) is lower than that in control group (24％),however,the incidence of operation characteristic complications had not statistical significance in two groups.Besides,the intestinal recovery time in the experimental group was shorter than control group (experimental group 36.56 hours,control group 45.24 hours,t =2.390,P =0.019).Conclusion The application of functional exercise pathway in postoperative enhanced recovery exercise of patients undergoing hepatectomy is safe and effective,which can reduce the patients' postoperative hospital stay,hospital costs,and the general incidence of complications incidence,and be helpful for the intestinal function recovery.

Objective To investigate the computed tomography (CT) and magnetic resonance imaging (MRI) features of the myomatous hepatic angiomyolipoma (MHAML).Methods The retrospective cross-setional study was conducted.The clinicopathological data of 22 patients with MHAML who were admitted to the Southwest Hospital of the Third Military Medical University between January 2010 and June 2016 were collected.Patients underwent plain and enhanced scans of CT and MRI,and then received pathological examination after surgical resection or liver puncture and immunohistochemical staining.Observation indicators:(1) findings of CT and MRI,2 radiologists independently read films;(2) diagnostic consistency of 2 radiologists;(3) results of pathological examination.The Kappa test was used for evaluating the consistency,κ ≥0.75 as a good consistency,0.40＜κ＜0.75 as a normal consistency and κ ≤0.40 as a poor consistency.Results (1) Findings of CT and MRI:of 22 patients,16 received CT scans and 6 received CT and MRI scans.Tumors of 22 patients were single lesion,showing similar-circular type.Tumors located in the right liver lobe,left liver lobe and caudate lobe were respectively detected in 14,7 and 1 patients.① Plain and enhanced scans of CT:tumors of 22 patients showed low density.Twenty patients had clear boundary of tumor and 2 had an unclear boundary.Tumors of 22 patients demonstrated obvious enhancement in arterial phase by enhanced scans of CT,including fast-in and slow-out enhancement in 10 patients and fast-in and fast-out enhancement in 12 patients.The draining veins inside tumors were detected in 12 patients in early arterial phase by enhanced scans of CT.The dilated blood vessels inside tumors were found in 12 patients.The ring enhancement of tumor margin was detected in 16 patients,with formation of small blood vessels involving tumor blood supply.② MRI scan:tumors of 6 patients presented as low signal on T1WI and high signal on T2WI.Of 6 patients,5 had clear boundary of tumor and 1 had an unclear boundary.Tumors of 6 patients demonstrated obvious enhancement in arterial phase by enhanced scans of MRI,with a fast-in and fast-out enhancement.The draining veins inside tumors were detected in 3 patients in early arterial phase by enhanced scans of MRI.The dilated blood vessels inside tumors were found in 1 patient.The persistent ring enhancement of tumor margin was detected in 5 patients,with formation of small blood vessels.All the lesions of 6 patients using GD-EOB-DTPA MR contrast-enhanced scan demonstrated restricted diffusion with a high b value (b=800 s/mm2),an average apparent diffusion coefficient of 1.549× 10-3 mm2/s (1.209× 10-3-1.796× 10-3 mm2/s) and low a signal in liver phase.(2) Diagnostic consistency of 2 radiologists:there were good diagnostic consistencies of 2 radiologists in tumor location,density,T1WI,T2WI,bleeding,enhancement method and dilated blood vessels (κ=1.00,1.00,1.00,1.00,0.82,0.82,P＜0.05).There were normal diagnostic consistencies of 2 radiologists in tumor fat,calcification,component of cystolization,boundary,draining veins and enhancement of tumor margin (κ =0.46,0.45,0.64,0.54,P＜0.05).(3) Results of pathological examination:results of pathological examination of tumors from surgical resection of 17 patients and liver puncture of 5 patients showed that smooth muscle cells were the major components,and thick-walled vessels were found in the tumor of 12 patients.Results of immunohistochemical staining showed that anti melanoma specific monoclonal antibody (HMB-45) was positive.Conclusion The persistent enhancement of tumor margin,draining veins in early arterial phase by enhanced scans and dilated blood vessels might play roles in diagnosis of MHAML.

Objective To investigate the critical value of TSH-stimulated Tg(sTg) in the diagnosis of metastasis from DTC, and to evaluate the diagnostic value of the ratio of sTg to suppressed Tg (sTg/suppressed Tg).Methods A total of 330 post-operative DTC patients(87 males, 243 females, age range: 12-70 years)who underwent thyroid remnant ablation from August 2008 to December 2014 were retrospectively reviewed.Their serum TgAb levels were normal.The patients were divided into non-metastasis group(147 cases)and metastasis group(183 cases) according to results of ultrasonography, CT and WBS.The difference of sTg between the two groups were compared by Mann-Whitney rank sum test.ROC curve was used to analyze the relationship between sTg, sTg/suppressed Tg ratio and metastasis, the cutoff value was calculated.Results The sTg was significantly different between the non-metastasis group and metastasis group: 1.0 (0.1, 2.0) μg/L vs 36.5 (3.9, 126.7) μg/L;u=-6.642, P<0.05.The AUC for ROC curve in metastasis group was 0.85, and the cutoff value was 2.05 μg/L, with the sensitivity 85.2%, specificity 67.3%, and accuracy 82.3%.While sTg<2.05 μg/L, the AUC of sTg/suppressed Tg ratio was 0.941, and the cutoff value was 4.3, with the sensitivity 93.3%, specificity 88.2%, and accuracy 92.3%.Conclusions The sTg has a specific value for the diagnosis of metastasis from DTC after operation and the cutoff value is 2.05 μg/L in this set of patients.The ratio of sTg/suppressed Tg could be used to correct the sTg and to improve the diagnostic sensitivity.