Objective To analyze the atypical CT and MRI findings of renal cell carcinoma (RCC) and to discuss how to improve the diagnostic accuracy of RCC using CT and MRI. Methods The data of 100 cases of RCC (71 males and 29 females;age range from 29 to 75 years with a mean of 55 years) were reviewed.The surgical and pathological findings showed clear cell carcinoma in 82 cases,mixed cell carcinoma in 8,granular cell carcinoma in 5,papillary RCC in 4 and sarcomatoid RCC in 1.A total of 101 masses were found.The masses were 0.8 to 9.0 cm (mean,4.3 cm) in greatest dimension. According to the CT and MRI findings of most cases in this group and the relevant information in literature,the typical CT and MRI findings of RCC were summarized. The atypical CT and MRI findings of RCC were analyzed,and correlated with surgical and pathological findings. Results There were 17 cases presenting with atypical CT and MRI findings.The atypical CT and MRI findings of RCC were divided into 4 types:① hypovascular RCC (12 cases,including 3 of clear cell carcinoma, 1 of mixed cell carcinoma, 5 of granular cell carcinoma and 3 of papillary RCC);②cystic RCC (3 cases of clear cell carcinoma);③RCC with volumes of hemorrhage (1 case of papillary RCC);④tumor's diameter less than 1㎝ (1 case of clear cell carcinoma). Conclusions Correct evaluation of the CT/MRI findings of hypovascular and cystic RCC,application of adequate scanning methods and careful interpretation of the imaging films are helpful for improving diagnostic accuracy of RCC.

Objective To evaluate the value of the corticomedullary phase ( CMP ) of CT and MRI scan for the differentiation of the subtypes of renal cell carcinoma ( RCC ) .Methods Ninety six cases of RCC proved by surgery and pathology were performed CMP scan with multislice helical CT and/or 1.5T MRI . The enhancement patterns of CT/MRI were correlated with the subtypes of RCC.Results There were 1 case of sarcomatoid RCC , 78 cases of clear cell RCC , 5 cases of granular cell RCC , 8 cases of mixed cell RCC and 4 case of papillary RCC . The masses were 2 cm to 9 cm in diameter . Sarcomatoid RCC, mixed cell RCC , 97.4% ( 76/78 ) of clear cell RCC and 75.0%(3/4) of papillary RCC showed inhomogenous enhancdment, and granular cell RCC showed homogenous enhancdment. Comparing with renal cortex, 51.3%(40/78) of clear cell RCC and 37.5%(3/8) mixed cell RCC showed hyperdensity or hypertension, sarcomatoid RCC, 44.9%(35/78) of clear cell RCC and 50.0%(4/8) mixed cell RCC showed isodensity or isotension, and all the granular cell RCC and papillary RCC showed hypodensity or hypotension.Conclusion The enhancement pattern in CMP of CT and MRI scan is different among the subtypes of RCC, and could be used for differentiation.

Objective To assess the CT manifestation an d its diagnostic value for renal milk of calcium (RMC). Methods Conventional CT examination was made for 14 patients of RMC and the imag es obtained were analyzed. Results CT clearly displayed the whole view of milky calcium cyst and its "half-moon sign". In 4 cases,th e half-moon high density formed by milk of calcium always located in the lowest part of the lesion with change of the body's position. All the lesions are unil ateral and their average diameter is 2.4 cm. Out of 14 patients, 13 are renal cy st type and 1 hydronephrosis type. Conclusions CT can di splay characteristic changes of RMC more clearly and distinguish it with other d iseases more reliably. CT can definitely discriminate types of RMC and provide more reliable pathologic and anatomic data.

Objective To study CT findings of gastrointestinal lymphoma.Methods Conventional and enhanced CT data of 25 gastrointestinal lymphoma patients proved pathologically by gastroscope(8 cases),enteroscope(3),operation(5)and lymph node of neck puncture(9) were retrospectively analysed.Results All cases were secondary gastrointestinal lymphoma except one primary located in cardia.CT manifestations of gastric lymphoma included three kinds:(1)Widespread infiltration or multiple type (9 cases);(2)Limited type(3 cases);(3)polypus type(1 case):which had not been found by gastroscope.The CT value range of tumor was 20～42 HU with average of 31.3 HU.Most tumours showed homogeneous contrast enhancement.Enhanced value range of tumor was 15～33 HU with average of 23.5 HU.CT manifestations of intestinal lymphoma included:(1)Multiple nodus type(4 cases);(2)infiltration type(5 cases);(3)mesentery involved type(3 cases);(4)lump type(3 cases).Thickening mural were homogeneous except one showed low attenuation in the center of one extremely thickening wall.Conclusion Gastrointestinal lymphomas have slight to medium enhancement on comtrast-enhanced CT,while the medium enhancement is characteristic finding of this lesion.

Objective To study imaging findings of solitary hepatic biliary hamartoma in adult in order to improve the understanding of this disease.Methods The imaging findings of solitary hepatic biliary hamartoma proved by surgery and pathology in 3 cases were retrospectively analyzed.There were one male and two female,the age was 28,43 and 76 years old respectively.B-ultrasound and CT were performed in three cases and MRI was done in one case.Results The masses ranged in diameter from 2 cm to 4 cm.The lesions were inhomogeneous slightly hypoecho or slightly hyperecho on B-ultrasound,slightly homogeneous or inhomogeneous hypodensity on plain CT scan,slight or medium homogeneous or inhomogeneous enhancement and delayed enhancement on contrast-enhanced CT scan,slight low signal intensity on T1WI and slight high signal intensity on T2WI,and rim enhancement on post-gadolinium images.Conclusion The findings of solitary hepatic biliary hamartoma in the adult are not of characteristics.It may be similar to common hepatic mass,such as metastasis,hepatic abscess and hepatic cavernous hemangioma.

H7N9 avian influenza is the latest subtype of influenza virus to emerge in the world. By April 17, 2013 in Shanghai, a total of 31 confirmed cases were reported, and 11 of these patients died. The epidemiological characteristics and the clinical progress of this new human flu infection are still not clear. Thirteen confirmed patients have now been treated in Shanghai Public Health Clinical Center. Among the first batch of patients, hospitalised at the beginning of April 2013, two who were admitted with the same estimated date of onset of disease had very different outcomes. After active treatment at the Centre, one recovered by April 18, 2013, but one patient entered critical condition and died on April 11, 2013. The clinical and laboratory characteristics in hospital are here analysed and compared to learn more about H7N9 avian influenza. Confirmation that the observed differences are valuable for prognosis and treatment decisions for H7N9 patients awaits authentication by analysis of more patients.
Influenza in Birds ; Influenza A Virus, H7N9 Subtype ; Communicable Diseases ; Laboratories

Objective: To analyze the characteristics and abnormalities of electrocardiograms (ECG) in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and to provide evidences for the prevention and treatment of cardiovascular diseases in HIV/AIDS patients. Methods: The ECG results of 1 131 HIV/AIDS patients and 5 622 non-HIV/AIDS subjects from Shanghai Public Health Clinical Center were involved. The abnormality rates and characteristics of ECG were compared between the two groups. CD4⁺ T lymphocyte counts, CD8⁺ T lymphocyte counts and CD4/CD8 ratios were measured in HIV/AIDS patients. The comparison between two groups was conducted by chi-square test. Logistic regression model was used to explore the factors associated with ECG abnormalities in HIV/AIDS patients. Results: There were 611 cases (54.02%) out of 1 131 HIV/AIDS patients with abnormal ECG. The common abnormal ECG types were sinus tachycardia 239 cases (39.12%), sinus rhythm with ST-T changes 115 cases (18.82%) and sinus bradycardia 55 cases (9.00%). There were 1 958 cases (34.83%) out of 5 622 cases of non-HIV/AIDS subjects with abnormal ECG. The common ECG abnormality types were sinus bradycardia 633 cases (32.33%), sinus rhythm with ST-T changes 463 cases (23.65%) and sinus arrhythmia 256 cases (13.07%). The abnormal rate of ECG in HIV/AIDS patients was significantly higher than that in non-HIV/AIDS subjects (χ²=140.39, P<0.01). The abnormal rates of ECG in HIV/AIDS patients <50 years old and ≥50 years old were both higher than those of non-HIV/AIDS subjects in the corresponding age group, and the differences were statistically significant (χ²=111.92 and 52.12, respectively, both P<0.01). Logistic regression analysis showed an increased risk of abnormal ECG in HIV-infected individuals compared with non-HIV/AIDS individuals (odds ratio (OR)=2.27, 95% confidence interval (CI) 2.00-2.60, P<0.01). The risk of ECG abnormality increased in patients aged ≥50 years(OR=1.60, 95%CI 1.45-1.77, P<0.01). The ECG abnormal distribution patterns were significantly different between different levels of CD4⁺ T lymphocyte counts, CD8⁺ T lymphocyte counts and CD4/CD8 ratios in HIV/AIDS patients (χ²= 12.92, 10.99 and 16.48, respectively, all P<0.05 ). The risk of ECG abnormality increased in HIV/AIDS patients aged ≥50 years (OR=1.50, 95%CI 1.15-1.96, P<0.01). When CD8⁺ T lymphocyte counts ≥500/μL, the risk of ECG abnormalities reduced (OR=0.75, 95%CI 0.58-0.96, P<0.01). Conclusions The abnormal rate of ECG in patients with HIV/AIDS is high. The sinus tachycardia and sinus rhythm with ST-T segment changes are common. The risk of ECG abnormality increases in HIV/AIDS patients aged ≥50 years old and reduces when the CD8⁺ T lymphocyte counts ≥500/μL. Type distribution of ECG abnormalities is associated with cellular immune status of patients.