OBJECTIVETo assess the feasibility of endobronchial ultrasonography (EBUS) in the differential diagnosis of malignant and benign lesions based on the two characteristic echo features of malignancy.

METHODSEBUS images from 102 patients undergoing bronchoscopy for peripheral lung lesions were analyzed. The sensitivity and specificity were determined for each echo feature, namely the halo sign and low-level echoes that indicated malignancy, or their combination in diagnosing malignant and benign lesions.

RESULTSLow-level echoes showed a sensitivity of 89.46% and a specificity of 83% in the diagnosis of malignancy, both higher than those of the halo sign (69.51% and 65%, respectively). The presence of either of the two echo features had a diagnostic sensitivity of 94.6% for malignant lesions, and the coexistence of the two features had a specificity of 93% for a diagnosis of malignant lesions.

CONCLUSIONEBUS is a useful adjunctive modality for lung cancer diagnosis, especially in cases where peripheral lung lesions are invisible in conventional bronchoscopy.

Diagnosis, Differential ; Endosonography ; methods ; Humans ; Lung Neoplasms ; diagnostic imaging ; Pneumonia ; diagnostic imaging ; Sensitivity and Specificity

Objective To study the diagnosis, management and prognosis of intracranial metastases of gestational trophoblastic tumour (GTT) patients who had emergency surgical decompression due to highly increased intracranial pressure. Methods Ninety-three patients with intracranial metastases of gestational trophoblastic tumour were hospitalized in our department of Peking Union Medical College Hospital from 1985 to 2004. Thirteen of them who underwent emergency craniotomy were retrospectively analyzed, and all of them presented with raised intracranial pressure and intracerebral haemorrhagic mass. Result Of the thirteen patients who underwent surgery in combination with multiagent systemic chemotherapy, seven achieved complete remission(CR), five had partial remission(PR), and one died of disease progression. Conclusions Emergency surgical treatment is the important method of choice for brain metastasis in patients displaying rapidly deteriorating signs. An undetermined intracranial haemorrhage in young female patients of reproductive age group should raise the suspicion of cerebral metastatic choriocarcinoma.

Objective:To investigate the effect of edaravone, a free radical scavenger, on the regulation of retinal autophagy and the protection of photoreceptor cells at the early stage of experimental retinal detachment (RD) in rats.Methods:Fifty-one adult male Sprague-Dawley rats were used for RD model establishment, and another 24 rats were served as PBS injection group.The RD model was established via subretinal injection of 0.5% sodium hyaluronate into the right eye of the rats and the rats with successful modeling were randomly divided into RD model group and edaravone treatment group.The rats in the edaravone treatment group were given edaravone of 3 mg/kg intraperitoneally, twice a day after modeling, and the rats in the PBS injection group and RD model group were given equal volume of normal saline.Rats were sacrificed on the 1st day, 3rd day and 7th day following modeling.The T-superoxide dismutase (T-SOD) activity and malondialdehyde (MDA) content in the intraocular fluid was detected.The expression levels of superoxide dismutase 2 (SOD2), nuclear factor E2-related factor 2 (Nrf2), autophagy related gene 4 (Atg4), microtubule-associated protein 1 light chain 3B (LC3B) and other proteins in retinal tissue were identified by Western blot analysis.TUNEL staining was performed on paraffin sections of the whole eyeball to analyze the apoptosis of photoreceptor cells.The study protocol was approved by an Ethics Committee of Xi'an Fourth Hospital (No. 2016016). The use and care of animals complied with the Regulations on the Administration of Experimental Animals.Results:The RD area was more than 60% in rat eyes of RD model.There were significant differences in MDA content and T-SOD activity among different groups at various time points (MDA: Fgroup=385.513, P<0.01; Ftime=13.021, P<0.01.T-SOD: Fgroup=48.865, P<0.01; Ftime=7.700, P=0.003). Compared with the PBS injection group, the MDA concentration was significantly increased and the T-SOD activity was significantly decreased in the RD group and edaravone treatment group on the 1st, 3rd and 7th day after modeling (all at P<0.05). The MDA concentration was significantly reduced and the T-SOD activity was significantly elevated in the edaravone treatment group on the 1st, 3rd and 7th day after modeling in comparison with those of the RD group (all at P<0.05). Compared with the PBS injection group, the relative expression levels of SOD2 and Nrf2 proteins were significantly increased in the RD group and edaravone treatment group on the 1st, 3rd and 7th day after modeling (all at P<0.05), and Atg4 and LC3B-Ⅱ/LC3B-Ⅰ were significantly increased on the 1st, 3rd and 7th day after modeling (all at P<0.05). The expression level of SOD2 in the edaravone treatment group was significantly higher than that in the RD group on the 1st, 3rd and 7th day after modeling (all at P<0.05), and the expression level of Nrf2 was significantly increased in the edaravone treatment group on the 1st and 3rd day after modeling compared with that of the RD group (both at P<0.05), and the expression levels of Atg4 and LC3B-Ⅱ/LC3B-Ⅰ were significantly increased in the edaravone treatment group on the 3rd day after modeling in comparison with those of the RD group (both at P<0.05). No significant TUNEL positive cells were observed in PBS injection group at all time points, and TUNEL positive cells were observed on the 1st, 3rd and 7th day after modeling in the RD group, and the expression level of caspase-3 in the RD group was significantly increased in comparison with that of the PBS injection group ( P<0.05). The apoptosis of photoreceptor cells and the expression level of caspase-3 in edaravone treatment group were significantly decreased in comparison with those of the RD group on the 1st, 3rd and 7th day after modeling (all at P<0.05). Conclusions:The intraperitoneal injection of edaravone, twice a day, can significantly improve the antioxidant capacity of the retina after experimental RD in rats, regulate retinal autophagy and reduce the apoptosis of photoreceptor cells in early-stage RD.

Background and objective Lung cancer is the leading cause of cancer death in men and women in the world, more than one-half of cases are diagnosed at a advanced stage, and the overall 5-year survival rate for lung cancer is 18%. Lung cancer is divided into non-small cell lung carcinoma (NSCLC) and small cell lung carcinoma (SCLC). Approximately 80%-85%of cases are NSCLC which includes three main types:adenocarcinoma (40%), squamous cell carcinoma (SCC) (20%-30%), and large cell carcinoma (10%). Although therapies that target driver mutations in adenocarcinomas are showing some promise, they are proving ineffective in smoking-related SCC. We need pay more attention to the diagnosis and treatment of SCC. 18F-FDG positron emission tomography (PET)/computed tomography (CT) has emerged as an accurate staging mo-dality in lung cancer diagnosis. hTe aim of this study is to investigate the role of maximum standardized uptake value (SUVmax) on PET-CT in prognosis and its correlation with clinicopathological characteristics in resectable SCC. Methods One hun-dred and eighty-two resectable SCC patients who underwent PET/CT imaging between May 2005 and October 2014 were enrolled into this retrospectively study. All the enrolled patients had underwent pulmonary resection with mediastinal lymph node dissection without preoperative chemotherapy or radiotherapy. Survival outcomes were analyzed using the Kaplan-Meier method and multivariate Cox proportional hazards model. Correlation between SUVmax and clinicopathological factors was analysed using Pearson correlation analysis and Spearman rank correlation analysis. Results hTe patients were divided into two groups on the basis of SUVmax 13.0 as cutoff value, and patients with SUVmax more than 13.0 had shorter median overall survival than patients less than 13.0 in univariate analysis (56 months vs 87 months;P=0.022). hTere was remarkable correla-tion between SUVmax and gender, tumor size, tumor-node-metastasis (TNM) stage, neutrophil, NLR, hemoglobin (P<0.05). Multivariate Cox analysis demonstrated that SUVmax (HR=1.714, 95%CI:1.021-2.876, P=0.042), TNM stage (HR=1.677, 95%CI:1.231-2.284, P=0.001) were independent predictors for survival. Furthermore, univariate survival analysis showed signiifcant difference by SUVmax in patients of stage I (P=0.045). Conclusion SUVmax may be of importance prognostic factor independent of TNM stage, which was considerable for risk stratiifcation in patients with TNM stage. Besides, there was correlation between SUVmax of primary tumor and clinicopathological characteristics.