Objective To evaluate the value of MR and CT examinations in the diagnosis of nasopharyngeal carcinoma (NPC) and compare 2008 staging system with 1992 staging system and 2002 UICC staging system for NPC. Methods MR and CT images of seventy-six cases with NPC were studied. According to 2008 staging system and taking MR as a standard, differences between these two examinations were evaluated under the new NPC staging system, and three staging system were compared by MR findings. Results MR was inconsistent with CT in eveluating invasion of medial pterygoid muscle(22,24 cases), lateral pterygoid muscle( 15, 11 cases), skull base(35, 32 cases) and intracranial fossa( 11,6 cases), but no statistical diffence existed ( P ＞ 0. 05 ). There were statistical difference ( P ＜ 0. 05 )between MR and CT in determining invasion of parapharyngeal space( 50, 61 cases), retropharyngeal lymph node metastasis(48, 23 cases), stage T1 (18, 11 cases), T2 (15, 22 cases), N0 (18, 24 cases) and N1(33, 27 cases) with differences of 11 cases, 25 cases, 7 cases, 7 cases, 6 cases and 6cases respectively.For invasion of parapharyngeal space, CT showed 11 cases more than MR while 5 cases were comfirmed as compression by local tumor and 6 cases were proved as retropharyngeal lymph node metastasis according to MR. For retropharyngeal lymph node metastasis, MR presented 25 cases more than CT. These two reasons above mainly caused the differences of T-staging and N-staging. For 2008 staging system, when compared with 1992 staging system, there were 9 cases upstaging and 1 case downstaging in T classification, 16 cases upstaging in N classification, and 15 cases upstaging and 1 case downstaging in clinical classification; and when compared with 2002 UICC staging system, there were 7 cases, 10 cases and 12 cases upstaging in T,N, and clinical staging respectively. Conclusions Compared with MR examination which was regarded as standard by 2008 staging system of NPC, there were some differences in demonstrating invasion of parapharyngeal space and retropharyngeal lymph node metastasis by CT. Compared to 1992 staging system and 2002 UICC staging system, 2008 staging system mainly made T and N classification of tumor upstage,resulting in upstaging in clinical classification.

Objective To investigate the value of DWI before treatment on predicting sensitivity of concurrent chemoradiation in nasopharyngeal carcinoma.Methods Seventy patients with nasopharyngeal carcinoma proved by nasopharyngoscope and biopsy pathology conducted DWI before concurrent chemoradiation and reexamined on receiving dose of 50 Gy.The mean, maximum and minimum ADC value of tumor were measured on DWI and maximum area of tumor before and during treatment ( on dose of 50 Gy) was delineated to calculate the tumor regression rate ( RS0-50 ).The patients were classified into three groups according to the RS0-50 as sensitive, moderate, and resistant therapeutic effect.Patients were classified into different groups according to the pathologic type and clinical stage respectively .Spearman correlation analysis was used between RS 0-50 and ADC values of all tumors , different pathologic types and clinical stages , respectively.ROC was used to evaluate the cutoff and value of ADC which had highest correlation to RS0-50 on predicting therapeutic effect.Results DWI of 3 patients were excluded due to obvious swallow artifact which influenced the measurement , and finally 67 patients were included in this study, with pathological type of nonkeratinized differentiated undifferentiated carcinoma in 49 cases, nonkeratinized undifferentiated carcinoma in 18 cases, clinical T1 stage in 7 cases, T2 in 14 cases, T3 in 17 cases and T4 in 29 cases.During treatment , there were 13 cases with sensitive therapeutic effect , 42 cases with moderate therapeutic effect and 12 cases with resistant therapeutic effect.RS0-50 [ ( 65.6 ± 3.1) %] showed mildly and moderately negative correlation to mean ADC [(1.06 ±0.19) ×10 -3 mm2/s] and maximum ADC [(1.29 ±0.33) ×10 -3 mm2/s] respectively ( r =-0.276, P =0.024 and r =-0.434, P=0.001, respectively).ROC showed when setting threshold at maximum ADC value of lower than 1.06 ×10 -3 mm2/s for predicting sensitive therapeutic effect , the specificity , sensitivity , and accuracy was 69.2%(9/13), 88.9%(48/54) and 85.1% (57/67), respectively, and when setting threshold at maximum ADC value of higher than and equal to 1.30 ×10 -3 mm2/s for predicting resistant therapeutic effect, the specificity, sensitivity, and accuracy was 75.0% (9/12), 65.5% (36/55) and 67.2%(45/67), respectively.Conclusion Pretreatment maximum ADC value were able to predict the tumor regression rate and sensitivity of concurrent chemoradiation in nasopharyngeal carcinoma .

Objective To evaluate 3.0T MR diffusion weighted imaging (DWI) and ADC value in diagnosis, histological grade, tumor staging and short-time therapeutic outcome of clear cell renal cell carcinomas (CCRCC). Methods DWI of 51 patients of CCRCC confirmed with surgery and pathology were retrospectively reviewed. ADC values of tumors and the corresponding areas of lateral normal renal parenchyma were measured. Taking ADC value at 1.8×10~(-3) mm~2/s as a cut-off value, the patients were divided into two groups. The tumors' histological grade, T-staging, clinical staging, tumor short-term control rate within 1 year follow-up were compared between the two groups with statistical test. Results Statistical difference of ADC value was observed between CCRCC ([1.778±0.582]×10~(-3) mm~2/s) and those of normal renal parenchyma ([2.314±0.223]×10~(-3) mm~2/s) (P<0.01). ADC values of 24 patients were less than 1.8×10~(-3) mm~2/s and those of 27 patients were more than or equal to 1.8×10~(-3) mm~2/s. There were statistical differences in histological grade, T-staging, clinical staging, tumor short-term control rate within 1 year follow-up between the two groups (P＜0.01). Conclusion 3.0T MR DWI can accurately differentiate CCRCC from normal renal parenchyma. Quantitative analysis of ADC value is helpful to evaluate the histological grade, tumor staging and short-term therapeutic outcome of CCRCC.

Objective To evaluate 3.0T MR diffusion weighted imaging (DWI) and ADC value in diagnosis of different pathological types and grades of malignant renal tumors. Methods DWI images of 66 patients of malignant renal tumors proved pathologically were retrospectively reviewed. ADC values of tumors and the corresponding areas of lateral normal renal parenchyma were measured and analyzed statistically. Results There was significant difference between the mean ADC value of malignant renal carcinomas ([1.653±0.598]×10~(-3) mm~2/s) and that of normal renal parenchyma ([2.305±0.218]×10~(-3) mm~2/s, P<0.001). ROC curve showed that taking ADC value of lower than 2.0×10~(-3) mm~2/s as a threshold for diagnosing renal malignant tumor, the specificity, sensitivity and accuracy was 93.94%, 71.21% and 82.58%, respectively. Statistical differences were found between clear cell carcinoma and non-clear cell carcinoma (P=0.001), as well as clear cell carcinoma grade Ⅰ and Ⅲ (P=0.002), grade Ⅱ and Ⅲ (P=0.004) respectively. However, no statistical difference was observed between grade Ⅰ and Ⅱ (P=1.000). Conclusion 3.0T MR DWI can be used in diagnosis of malignant renal tumors, and ADC value may help to differentiate the pathological type and grade.

Purpose To investigate the clinicopathologic and immunohistochemical features,and differential diagnosis of nephrogenic metaplasia (NM).Methods The clinical data,histological and immunohistochemical characteristics of 6 cases of NM were analyzed,with review of the literature.Results There were 1 case of female,5 cases of male,aged from 31 to 81 years,with average of 58.1 years.The history revealed lithiasis of urologic tact in 2 cases,previous transurethral resection for benign prostatic hyperplasia or cystitis glandularis in 3 cases,and concurrent urothelial carcinoma in 1 case.The lesion involved in the ureter in 3 cases,prostatic urethra in 2 cases,and bladder trigone in 1 case.Cystoscopic examination demonstrated mucosal rough or low villous protrude.Microscopically,the lesion was consisted of tubules,cysts,small nests and papillary structures with basement membrane-like eosinophilic sheath,and lined by cuboidal,or low column epithelial cells with cytological atypia in some area,and shown inflammation in stroma.Immunohistochemically,there was positive staining for PAX2,PAX8,CK7 and P504S,negative for p63,CD10,and PSA.Conclusion NM is a rare tumor-like lesion often with injure of urologic tract,and should be differential with urothelial carcinoma,prostatic carcinoma,clear cell adenocarcinoma and endometriosis.It's important to know the clinicopathological and immunohistochemical features of NM for the correct interpretation.

Objective To analyze the causes for diffuse bone marrow uptake of 18F-FDG on PET/CT scans. Methods Sixty-six patients with diffuse bone marrow uptake on whole-body FDG-PET/CT imaging were enrolled for this study. Seventy-nine healthy subjects ( with no history of tumor or recent fever) were selected as normal control. The SUVmax and SUVmean were measured in bone marrow and mediastinum in both groups. The maximum (bone marrow SUVmax/ mediastinum SUVmax) and mean value ratios (bone marrow SUVmean/ mediastinum SUVmean) were calculated. Statistical analysis was performed by one-factor variance analysis. Results With diffuse bone marrow uptake pattern of 18F-FDG, 27 were caused by injection of hematopoietic growth factor, 21 by hematopathy and 18 due to fever. SUVmeanof those three causes were 3.076±1.955, 3.633±2.405 and 2.546±0.791 respectively, each was significantly different from that of the control group (1.026±0.190; F =34.465, P<0.001). Conclusion Diffuse bone marrow uptake on FDG-PET/CT are caused by both benign and malignant reasons.

Objective:To introduce a novel ridge preservation technique with micro-titanium plate avoiding the use of bone grafting materials,and evaluate the potential horizontal bone preservation effect of this new technique,applied on single maxillary central incisors after tooth extraction for future implant restoration.Methods:Nine patients (six women and three men),mean age (26.0 ±5.7)years(from 1 8 to 34 years)referred to the Department of Oral Implantology,Peking University School and Hospital of Stomotology,were selected and diagnosed with unsalvageable single middle incisor with fine general con-ditions,no signs of acute local inflammation,no ongoing or previous periodontitis,healthy neighboring teeth and intact buccal bone walls.Tooth extraction,delayed implant placement and implant-supported single crown restoration were selected as treatment plan.The teeth were extracted atraumatically with lo-cal anesthesia,followed by a reflection of a minor flap to exposed 2-3 mm of the buccal bone plate.Af-ter that,a micro-titanium plate was trimmed and bended to fit the convexity of the labial bone and fixed by two mini pins with intent to support the labial soft tissue.The flap was then repositioned over the micro titanium plate and secured with two single sutures.No bone grafting materials or releasing incisions were needed.The sockets were left to heal without any intention of primary wound closure.Cone-beam compu-ted tomographic (CBCT)scans were obtained before and four months after tooth extraction.Horizontal ridge widths were measured with CBCT software,and the preservation effects were calculated and recor-ded by the percentage of horizontal ridge alteration.Results:The nine extraction sockets were healed un-eventfully.The average socket width before extraction was (7.51 ±0.48)mm (6.92-7.82 mm).The average alveolar ridge labial-palatal width at the control point of the edentulous area was (6.81 ±0.44) mm (6.04-7.38 mm)4 months after tooth extraction,the mean percentage of ridge width preserved was 90.87%±2.91%(87.28%-95.60%).Conclusion:This novel ridge preservation method by the usage of a micro-titanium plate did not interfere with the natural socket healing process,and at the same time,largely preserved the width of alveolar ridge without any bone grafting procedures.Long term results remain to be seen.

Abstract： Objective　To analyze the value and influencing factors of cross-primer isothermal amplification technology(CPA) in clinical screening and diagnosis of tuberculosis (TB). Methods　We collected 543 inpatients in the Second Affiliated Hospital of Hainan Medical College from January 1, 2018 to December 31, 2021, including 179 patients with tuberculosis, 187 patients with pneumonia and 177 patients with other diseases. The patients' sputum, alveolar lavage fluid, pleural effusion and midstream urine were detected by CPA, smear microscopy, culture method and gene detection. The value of CPA detection in the diagnosis of tuberculosis and its influencing factors were evaluated. Statistical analysis was performed using SPSS 26.0. Results　The total positive rate of CPA was 14.4% (78/543), and the positive rate of sputum samples accounted for 29.1% (39/134). Among the 78 cases of CPA positive patients, the tuberculosis group accounted for 69.2% (54/78), followed by pneumonia group 21.8% (17/78), and other diseases group accounted for 9.0% (7/78). Taking CPA test as the reference method, the "sensitivity" of smear microscopy was lower than that of genetic testing and culture, while the "specificity" was higher than that of culture and gene testing, and the "missed diagnosis rate" of smear microscopy was higher than that of genetic testing and culture. CPA test positive was related to gender, ESR and pneumonia. There is a good agreement between CPA test and culture method and gene test (Kappa>0.9), and a moderate agreement between CPA test and smear microscopy (Kappa=0.616). Conclusions　Sputum specimen is the best choice for CPA detection, while the value of pleural effusion detection is relatively limited. Sputum, alveolar lavage fluid and midcourse urine can be used as clinical specimens for screening and diagnosis of "tuberculosis group and other disease group", while sputum can be used for screening and diagnosis of "tuberculosis group and pneumonia group". Gender, ESR and pneumonia are the influencing factors of CPA positive patients. Therefore, CPA testing is worthy of clinical promotion, but more clinical research data are needed.

This study was purposed to investigate the effect of different compositions and concentrations of lyophilizing protectants on recovery of RBCs and hemoglobin (Hb) after rehydration of lyophilized RBCs. The RBC lyophilizing protectants composed of a series concentrations of PVP, trehalose and different osmotic protectants were applied for protecting lyophilizing process of RBCs, the recovery of RBCs and Hb after rehydration of lyophilized RBCs was detected. The results showed that there were significant differences in loss ratio of RBCs between protectants composed of different compositions and concentrations (p<0.05 or p<0.01). The loss ratio of RBCs in protectant containing 30% PVP40, 150 mmol/L trehalose and 2% BSA was minimum (0.02%), the loss ratio of RBCs in protectant containing 6% PVP 360, 100 mmol/L trehalose and 2% BSA was maximum (0.27%). The difference of effect between 150 and 50 mmol/L trehalose was statistically significant (p<0.01). The recovery rates of RBCs and Hb in protectants contained PVP40 of different concentrations were different after rehydration of lyophilized RBCs. The protectant containing 15% PVP40, 150 mmol/L trehalose and 2% BSA showed optimal protective efficacy for lyophilized RBCs, the recovery rates of RBCs and Hb were 61.29+/-4.11% and 62.49+/-5.91% respectively, which were statistically different from other protectants (p<0.01). The protectants containing glycerol displayed best efficiency in lyophilization too, the recovery rates of RBCs and Hb were 65.97+/-4.52% and 67.24+/-5.94%, respectively. It is concluded that the protectants composed of 0.8 mol/L glycerol, 15% PVP40, 150 mmol/L trehalose and 2% BSA (pH 7.3 ) may be used as the protectant lyophilizing human RBCs in future study.
Blood Preservation ; methods ; Cryoprotective Agents ; administration & dosage ; analysis ; Erythrocytes ; Freeze Drying ; methods ; Humans ; Trehalose ; administration & dosage ; analysis

Objective:To explore the inhibitory effect of moxibustion on tumor growth and metastasis, and also its possible mechanism, in gastric tumor-bearing rats by investigating the expressions of vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF). Methods:Fifty healthy Sprague-Dawley (SD) rats (half male and half female) were routinely housed for 1 week. A total of 20 rats were randomly divided into a blank group and a sham operation group, with 10 rats in each group. The remaining 30 rats were used to make gastric cancer models by implantation of ascites-type Walker-256 cancer cells. After successful modeling, rats were randomly divided into a model group, a moxibustion group and an infrared group, with 10 rats in each group. From the day of modeling, the body weight of each group was weighed every 4 days. Warm moxibustion was alternately performed at two-group acupoints [Zhongwan (CV 12), Guanyuan (CV 4) and bilateral Zusanli (ST 36) in one group, and bilateral Pishu (BL 20) and Weishu (BL 21) in another group] in the moxibustion group. The body surface projection area of the stomach was irradiated with short-wave infrared rays in the infrared group, once a day, 20 min per time for 21 d. At the end of the treatment, the gastric tumor was completely dissected, and the tumor volume and tumor growth inhibition rate were calculated. Then the gastric tumor cell metastasis was recorded. The levels of VEGF and EGF in rat gastric tumor tissues were determined by enzyme-linked immunosorbent assay (ELISA). Results:Compared with the blank group, the body weight of the model group decreased significantly after modeling (P<0.05); compared with the model group, the rats in the moxibustion group had increased body weight during the middle and late stages (bothP<0.05). The tumor volumes of rats in the moxibustion group and the infrared group were smaller than the volume in the model group (bothP<0.05). The tumor growth inhibition rate in the moxibustion group was significantly higher than that in the infrared group (P<0.05). The case number of tumor metastasis in the moxibustion group was smaller than that in the model group and the infrared group. The VEGF level in the tumor tissues of the model group was statistically significantly higher than that in the blank group (P<0.05). Compared with the model group, the VEGF levels in the moxibustion group and the infrared group were statistically significantly lower (bothP<0.05). The EGF levels in the tumor tissues of the model group was statistically significantly lower than that in the blank group (P<0.05); compared with the model group, the EGF levels in the moxibustion group and the infrared group were statistically significantly increased (bothP<0.05). Conclusion:Moxibustion can increase the body weight, inhibit the tumor growth, invasion and metastasis in gastric tumor-bearing rats, which may be related to the regulation of VEGF and EGF expressions in tumor tissues.