ObjectiveTo compare the CT features of retroperitoneal ganglioneuroblastoma (GNB) and neuroblastoma (NB) in children,and summarize the differentiations between them.Methods From November 2007 to November 2011,19 patients with GNB and 21 patients with NB proven pathologically were enrolled in the study.The CT data of GNB and NB were analyzed retrospectively.These tumor parameters in CT included lesion location,size,shape,margin,calcification,across central line,style of contrast enhancement,degree of contrast enhancement,presence of small vessels in or around the tumor arranged in clumps or in line,tumor embolus,adjacent organs invasion or metastasis,lymph node metastasis,and relationship between tumor and surrounding great vessels.These parameters of both groups were compared by x2 and t test.ResultsIn GNB group,11 patients were located in adrenal gland and 8 patients in the retroperitoneal sympathetic chain; however,in NB group,18 patients were located in adrenal gland and 3 patients in the retroperitoneal sympathetic chain. The difference were statistical significances in the incidence rate of regular morphology,clear border,vessel encased by tumor,vessels displaced,presence of small vessels in /around the tumor arranged in clumps or in line,adjacent organs invasion or viscera metastasis,lymph node metastasis between NB (6/21,7/21,14/21,7/21,11/21,10/21,and 11/21,respectively) and GNB ( 12/19,13/19,6/19,13/19,4/19,3/19 and 4/19,respectively) ( P ＜ 0.05 ).However,there was no statistical significance in size,calcification,across central line,contrast enhancement type,contrast enhancement degree between them ( P ＞ 0.05 ).ConclusionsNB are more likely located at adrenal gland and presented a higher incidence rate of presence of small vessels in or around the tumor which arranged in clumps or in line,vessel encased by tumor,adjacent organs invasion or metastasis and lymph node metastasis.Regular morphology,clear border and vessels displaced are more frequently observed in GNB.

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Objective To investigate the effects of sirolimus and 3-methyladenine (3-MA) on the autophagy in,as well as matrix matalloproteinase (MMP)-1 and MMP-3 secretion by,human skin fibroblasts (HSFs).Methods HSFs were isolated from the circumcised foreskin of a healthy male,and subjected to primary culture.After 3 to 10 passages,HSFs were incubated with sirolimus of 20,50,100,250 nmol/L and 3-MA of 0.5,2.0,5.0,10.0 mmol/L respectively for 4 hours followed by the observation of autophagy and detection of MMP-1 and MMP-3 levels in the supernatant by enzyme linked immunosorbent assay (ELISA).Those HSFs remaining untreated or treated with dimethyl sulfoxide served as the control.Results The percentage of autophagy-positive cells was 59.075％ ± 6.884％,76.350％ ± 5.226％,85.063％ ± 6.002％,86.288％ ± 5.558％ and 96.825％ ± 1.500％ respectively in HSFs treated with sirolimus of 0,20,50,100 and 250 nmol/L; significant differences were observed between the 5 groups (P ＜ 0.01 ) but not between the cells treated with sirolimus of 50 and 100 nmol/L (P ＞ 0.05).After being treated with 3-MA of 0,0.5,2.0,5.0 and 10.0 mmol/L,the percentage of autophagy-positive cells in HSFs was 63.037％ ± 5.876％,34.425％ ± 5.183％,19.700％ ± 3.028％,12.900％ ± 3.334％ and 7.775％ ± 2.293％ respectively with a significant difference between these groups (all P ＜ 0.01 ).Elevated levels of MMP-1 and MMP-3 were observed in the supernatant of HSFs treated with sirolimus of 250 nmol/L and 3-MA of 10.0 mmol/L (all P ＜ 0.05).Conclusions The autophagy in HSFs can be upregulated by sirolimus,but downregulated by 3-MA.For the secretion of MMPs by HSFs,3-MA and high concentrations of sirolimus exert a promotive effect,and the effect of 3-MA is in a concentration-related manner,but the influences of sirolimus at lower concentrations remain unclear.

Objective The aim of this retrospective study was to analyze the role of surgery in the management of limited-stage-Ⅱ small cell lung cancer.Methods A retrospective review of 82 patients with limited-stage Ⅱ small cell lung cancer between January 2001 and December 2009 was performed.The prognostic impact of different therapy and the clinicopathologic factors were analyzed.Using SPSS 16.0 statistical software for data analysis.Log-rank test for the difference of survivale rate.Using the Cox model for muliti-factor survival analysis.Chi-square test for local recurrence and distant metastasis rate.Results The overall median survival time and the 1-,3-,and 5-year overall survival rates were 27.0 months,62.1％,35.9％,and 21.0％,respectively.Median survival was 34.0 months in surgical patients vs 16.0 months in nonsurgical patients (P =0.000).Median survival after lobectomy or pneumonectomy was significantly longer than after wedge resection (P =0.048).However,survival after wedge resection was still significantly longer than survival in nonsurgical patients(P =0.024).Survival analysis confirmed that the operation,chemotherapy and radiotherapy were showed to be independent prognostic factors.The local-regional recurrencer rates of lobectomy or pneumonectomy group was lower than wedge resection group(P =0.030).The distant metastasis rates of lobectomy or pneumonectomy group was lower than nonsurgical grou (P =0.021).Conclusion This study suggests that lobectomy or pneumonectomy combined with adjuvant radio-chemotherapy should be recommended for patients with limited-stage Ⅱ small cell lung cancer.

Objective To investigate the CT features of hepatic focal nodular hyperplasia (FNH) in children.Methods Thirteen patients with FNH,which was confirmed by postoperative pathology,were enrolled retrospectively.Plain and contrast CT were performed on all patients before operation.The CT imaging features of FNH including size,shape,density,style of contrast were analyzed retrospectively and compared with pathology.Results There were 13 patients with 16 lesions,8 lesions were found in the right lobe,5 lesions in the left lobe and 3 lesions involving both lobes.The tumor size ranged from 5.5 cm to 11.5 cm (media size 7.5 cm) in diameter.Histologically,2 cases were typical type,11 cases were atypical type.The lesions were regular morphology in 12 cases and 1 case with capsule.On plain CT,the lesions were isodensity (n=1) or slightly low-density (n=12).In 2 typical type lesions,there were slit-like,stellate-shaped low density central scars.Arterial phase demonstrated that 12 cases were significantly enhanced and 1 case showed mild enhancement.The central scar was not enhanced.In 12 cases,thickened and torturous arteries were seen.The enhancement was reduced at the portal venous phase in all the lesions,with 10 cases showing slightly higher density,2cases isodensity and 1 case low-density.Two cases showed mild enhancement of the central scar.The enhancement of the solid portion in all lesions decreased at the delay phase,with 12 cases showing isodensity and 1 case slightly low density.Two cases with central scar showed delayed enhancement with slightly higher density.Conclusion The CT features of FNH in children are diversified but distinctive which are related with postoperative pathological findings.Combining with clinical symptoms and CT features can be helpful for the early diagnosis of FNH in children.

Objective To evaluate the locating effects of a portable ultrasound for leg perforator flaps,and the clinical effects of leg perforator flaps for the wounds of the extremities.Methods Since December 2009 to March 2011,thirty-one cases of soft tissue defects of the extremities were treated with free vascularized leg perforator flaps in our center.A portable ultrasound were used for the locating of the perforator arteries of the leg before the operations.These flaps include 24 cases of the fibular artery perforator flaps (4 with simultaneous fibula transfer),three cases of the posterior tibia artery perforator flap,two cases of the medial gastrocnemius artery perforator flap,and 2 cases of the lateral gastrocnemius artery perforator flap.The flap size ranged from 15.0 cm × 8.0 cm to 1.0 cm × 1.5 cm.The caliber diameter of the perforator artery ranged from 0.2 mm to 1.8 mm.The wounds included 21 cases of the hand,five cases of the forearm,and 5 cases of the leg.Results The coincidence rate intraoperatively of the portable ultrasound was 96.8％.All the flaps survived and the wounds healed uneventfully.The donor site of the flaps were either closed directly or closed with partial split-thickness skin graft.Conclusion The portable ultrasound is an effective,reliable and accurate instrument for locating the leg perforator flaps.The leg perforator flaps have the advantages of convenient harvest,satisfactory thickness,less donor site morbidity,and high survival rate.

Objective To compare the results and safety between video-assisted thoracoscopic surgery ( VATS ) and conventional radical operation in patients with stage Ⅰ , Ⅱ esophageal cancer. Methods Retrospectively reviewed 43 patients with stage Ⅰ , Ⅱ esophageal cancer,underwent either VATS radical operation (VATS group,16 cases) or conventional radical operation (control group,27 cases ) from September 2007 to September 2009. Patient's operative characteristics and postoperative courses were compared between two groups. Results In VATS group the operation time was ( 115.6 ± 48.0) min,the peri-operative blood loss was ( 131 ± 71 ) ml,the first postoperative day chest lead quantity was (331 ± 170)ml, the time of postoperative chest tube was (7.25 ± 2.35) d,the postoperative 36 h visual analogue scale (VAS) was (3.4 ± 1.2) scores,the postoperative drainage of chest was ( 1281 ± 534) ml,the 72 h postoperative locomotor activity of right upper extremity was (5.1 ± 1.5) cm. While in control group was ( 145.6 ± 20.6)min, (292 ± 111 ) ml, (494 ± 194) ml, ( 10.00 ± 2.79 )d, (7.3 ± 1.4) scores, ( 1780 ± 731 ) ml, ( 15.6 ± 3.1 )cm respectively (P ＜ 0.01 or ＜ 0.05 ). The lymph node dissection number,the total cost of hospital between were no statistically significant differences in two groups (P ＞0.05). Conclusion Comparing with conventional radical operation, VATS radical operation for patients with stage Ⅰ , Ⅱ esophageal cancer appears to be as effective but less morbid.

Objective To observe the changes of autophagy in human skin fibroblast (HSF) model for photoaging. Methods HSF model for photoaging was established through repeated exposure to ultraviolet B (UVB). Those HSFs receiving no irradiation served as the control. The degree of aging was evaluated by p-galactosidase assay, and autophagy level was detected. Results After repeated exposure to UVB, most pho-toaged HSFs were deformed and distorted, and some of them even died. The percentage of P-galactosidase-positive cells was 50.60% ± 5.04% and 14.58% ± 2.69%, respectively in photoaged and control HSFs (P< 0.01). Significant difference was also observed in the proportion of cytophagosome-positive cells between photoaged and control HSFs (14.91% ± 4.59% vs 68.45% ± 8.25%, P < 0.01). Conclusion The HSF model for photoaging shows obviously abnormal appearance and stagnant growth with increased degree of senescence and decreased autophagy compared with normal control HSFs.

Objective To study the alterations of CD19+CD5+CD1dhigh B, Th1 and Th17 cells in non-obese diabetic ( NOD) mice and the correlation between B10 cells and type 1 diabetes in NOD mice. Methods Flow cytometry ( FCM) was used to measure the levels of CD19+CD5+CD1dhigh B, CD19+IL-10+B, CD4+IFN-γ+Th1, CD4+IL-17+Th17 and CD4+CD25+Foxp3+T cells in NOD mice ( 4 weeks old NOD mice:group A, n=10;8 weeks old NOD mice:group B, n=10; NOD mice with diabetes: group C, n=10) and age-matched C57BL/6 mice ( control group, n=20 ) .Hematoxylin-eosin staining of pancreatic tissues was performed for histopathological assessment of the development of insulitis in NOD mice.Results (1) Histopathological analysis showed that mice from A, B and C groups respectively showed no insulitis, insulitis and obvious insulitis with no intact islets.(2) The highest levels of B10 cells in NOD mice were ob-served in group B, followed by those in group C and group A (P<0.01).No significant differences with the levels of B10 cells were found among different tissues of 4 weeks old NOD mice (P>0.05).More B10 cells were detected in pancreatic lymph nodes than in other tissues of 8 weeks old NOD mice, the levels of which were also higher than those in pancreatic lymph nodes of mice form group C ( P<0.01) .The highest levels of B10 cells were detected in peripheral lymph nodes among all tissues samples collected from NOD mice with diabetes (P<0.01).(3) The levels of Th1 and Th17 cells in mice from group C were remarkably in-creased as compared with those in mice from group A and B (P<0.01).(4) The percentages of CD4+CD25+Foxp3+T cells in mice from group C showed no differences with those in mice from A and B groups. No significant difference with Treg cells were observed between NOD mice and age-matched C57BL/6 mice (P>0.05).Conclusion The percentages and distribution of B10 cells in NOD mice changed with age and the development of insulitis.The decrease of B10 cells might participate in the development of type 1 diabe-tes in NOD mice.

Objective To investigate the CT features of hepatic mesenchymal hamartoma (HMH)in children.Methods Nine patients with HMH confirmed by postoperative pathology were enrolled,including 4 were males and 5 were females.Their age ranged from 3 days to 9 years 5 months (the median age was 7 months).All patients admitted due to palpable abdominal mass without jaundice.All patients were examed by contrast-enhanced CT before the operation.Results All the 9 cases showed solitary hepatic mass,among which 6 were in the right lobe,2 were in the left lobe and 1 involved in both lobes.The tumor size ranged from 7.0 to 22.5 cm (mean size was 13.5 cm) in diameter.The CT manifestations of HMH was related to the proportion and distribution of component in the masses.The masses were cystic (n =1),cystic-solid mixed (n =6) and solid (n =3).After contrast administration,the solid component and the septa of the mass showed enhancement while cystic component was not enhanced.Calcification was seen inside the tumor in one case.Conclusions The CT features of HMH in children are multitudinous which are related to postoperative pathological findings.With the clinical history,it is easy to distinguish HMH from the other hepatic tumors.