Objective (1)To observe the imaging features of the normal anatomic structures of middle ear using CT virtual endoscopy.(2)To study morphologic changes of ear ossicles and auditory ossicular chain of patients with conductive deafness.Methods CTVE of the auditory ossicular chain was performed on GE Hispeed CT/I with 1.0 mm slice thickness at pitch 1, bone algorithm, voltage 140 kV, electric current 170～220 mA, 9.6 cm field of view.Results CTVE could clearly demonstrate the normal auditory ossicular chain and its anatomic details. The demonstration rate of CTVE images in detecting the malleus-incus joint was 100%(162/162), in detecting "L"type incus-stapes joint was 80%(130/162), in detecting the anterior and posterior stapes footplate was 73%(121/162); CTVE could well display the destruction of auditory ossicular chain in otitis media and cholesteatoma and could acurately show the malformation of the auditory ossicular chain.Conclusion CTVE can quickly, non-invasively, three-dimensionally display the middle ear auditory ossicular chain, can provide direct and reliable imaging information for discovering the cause of a disease of conductive deafness.

Objective To retrospectively evaluate the role of consolidative repeat radiofrequency ablation (CRRFA) based on safety margin (SM) analyses in local tumor control for alpha-fetoprotein (AFP) negative hepatocellular carcinoma (HCC) patients who had been shown to have radiological complete ablation (CA) with radiofrequency ablation (RFA). Methods From July 2002 to July 2009,152 AFP negative HCC patients who were shown to have radiological CA with RFA therapy were retrospectively analyzed. Among them, 110 patients had a SM of less than 1 cm and the other 42 patients had a SM of 1cm or more. Among 110 patients with SM less than 1 cm, fifty nine patients accepted CRRFA within 6 months after the first RFA and 51 did not. From these patients, a narrow SM-CRRFA group (n=41) and a narrow SM-single RFA group (n=37) were enrolled respectively. The wide SM-single RFA group (n= 30) was enrolled from the 42 patients with a SM of 1 cm or more.The LTP (local tumor progression)-free survival rate of the 3 groups were compared with a log-rank test. Results One-, two-, three-, four-, and five-year LTP-free survival rates respectively were 97. 1%, 90.9%, 69.6%, 47.2%, and 33. 0% in the narrow SM-CRRFA patients. 85.9%, 66. 5%,43.5%, 15.8%, and 0. 0%, in the narrow SM-single RFA patients, and were 92.7%, 83.7%,59.3%, 36. 9%, and 9.2% in the wide SM-single RFA patients. There were statistically significant differences (χ2 = 14. 789, P= 0. 001) between the groups. Conclusions An ablation zone with an SM of 1 cm or greater was the most important factor for local control of AFP negative HCC ranging from 3 to 5 cm in diameter. For these patients with a SM of less than 1 cm, CRRFA improved the overall local control outcomes.

ObjectiveTo observe the effect of different extracts ofTangwang Mingmu Granule on hypoxia induced gene expressions in vascular endothelial cells.Methods COCl2 intervention cells were used to copy hypoxia models. Human umbilical vein endothelial cells EA. Hy926 were divided into blank group, hypoxia model group,Tangwang Mingmu Granule group, extract 1 (glycosides and flavonoids) group, extract 2 (orgain acids and polysaccharides) group and extract 3 (alkaloids) group. The changes in gene expressions of VEGF, VEGFR-1, VEGFR-2, ICAM-1 and IL-1α mRNA were detected by semi-quantitative RT-PCR.ResultsThe gene expression levels of VEGF, VEGFR-1, VEGFR-2, ICAM-1 and IL-1α were significantly up-regulated under the hypoxic condition (P<0.05), and the ratio of VEGFR-1/VEGFR-2 was significantly reduced. However,Tangwang Mingmu Granule significantly reversed the expressions of these genes.Conclusion The function intensity of gene expressions weakens in the following sequence:glycosides and flavonoids>alkaloids>organic acids and polysaccharides inTangwang Mingmu Granule.

Objective To observe the effects ofTrametes robiniophila Murr and Isatidis Radix bidirectional fermentation products on the migration and invasion of human breast cancer MCF-7 cells and relevant factors; To discuss relevant mechanism of action.Methods Breast carcinoma cell line MCF-7 was used as research subject in this experiment. Control group, Isatidis Radix group,Trametes robiniophila Murr group, andTrametes robiniophila Murr and Isatidis Radix group were included in the experiment. The effects ofTrametes robiniophila Murr and Isatidis Radix bidirectional fermentation products on MCF-7 cell proliferation were measured by MTT method. Cell scratch assay, transwell assay and adhesion assay were used to measure the effects ofTrametes robiniophila Murrand Isatidis Radix bidirectional fermentation products on the migration, invasion and adhesion capability of MCF-7 cells, respectively. The effects ofTrametes robiniophila Murrand Isatidis Radix bidirectional fermentation products on the mRNA expression of MMP-9 and Vimentin were measured by RT-PCR.Results Compared with Isatidis Radix group andTrametes robiniophila Murrgroup, Trametes robiniophila Murr and Isatidis Radix bidirectional fermentation products could significantly inhibit the proliferation, migration, invasion and adhesion capability of MCF-7 cells (P<0.05). Similarly,Trametes robiniophila Murr and Isatidis Radix bidirectional fermentation products reduced the mRNA expression of MMP-9 and Vimentin (P<0.05).ConclusionTrametes robiniophila Murrand Isatidis Radix bidirectional fermentation products may down-regulate the expression of MMP-9 and Vimentin to inhibit the migration, invasion and adhesion capabilities of MCF-7 cells.

Objective To observe the mechanism of action of different extracts ofTangwang Mingmu Granules on high glucose induced VEGF and IL-1α gene and protein expressions in vascular endothelial cells.Methods Human umbilical vein endothelial cells EA.hy926 were divided into six groups: blank, high glucose,Tangwang Mingmu Granules, extract 1 (glycoside and flavonoid), extract 2 (organic acid and polysaccharides) and extract 3 (alkaloids) groups. High concentration glucose was used to establish the high glucose model in EA.hy926 cells. The expressions of VEGF and IL-1α mRNA were detected by semi-quantitative RT-PCR. The contents of VEGF and IL-1α protein were tested by ELISA.Results The gene expression and protein levels of VEGF and IL-1α were significantly up-regulated under the high glucose condition (P<0.05). However, the above indicators were significantly reduced after the treatment ofTangwang Mingmu Granules. The activity of different parts ofTangwang Mingmu Granules was as follows: extract 1> extract 3> extract 2.Conclusion The action intensity of glycosides and flavonoids, alkaloids, organic acids and polysaccharides on VEGF and IL-1α expression inTangwang Mingmu Granules weakens in sequence.

Purpose:To evaluate the role of multi - detector row CT(MDCT) using reconstruction techniques in the assessment of patients with obstructed diseases of biliary tract.Materials and Methods: 47 Patients with obstructed diseases of biliary tract confirmed clinically underwent MDCT and their reconstructed images of biliary tract including multi-planar reconstruction (MPR) images and curved planar reconstruction(CPR) images were compared with those of 50 patients without obstruction and dilatation of biliary tract.The display effect of biliary duct structure and biliary duct wall and the display ability of biliary tract by MPR and CPR images between the 2 groups were compared and analysed.The reconstruction images of biliary tract were analysed retrospectively to evaluate the location and possible causes of biliary obstruction.Results: The display effect of biliary duct structure and biliary duct wall in MPR and CPR images of the group with biliary obstruction is better than that of control group,and the display ability of biliary tract in CPR images of the group with biliary obstruction is also better than that of control group.The accuracy of localization and cause evaluation of obstruction by MPR and CPR images is 100% and 89.4% respectively.Conclusions: The MPR and CPR images of MDCT provide a good display of biliary duct structure,biliary duct wall and an accurate evaluation of obstruction localization.The reconstruction technique of MDCT such as MPR and CPR should be widely applied in the evaluation of biliary obstruction.

PurposeAlteration of the regional cerebral flow and cerebrovascular reserve (CVR) caused by cerebral artery stenosis or occlusion is an essential risk factor for ischemic stroke. This study aims to assess the CVR in patients with severe middle cerebral artery (MCA) stenosis or occlusion by using MR perfusion-weighted imaging (PWI) with CO2 inhalation stress test. Materials and MethodsPWI were performed before and after CO2 inhalation stress on 28 patients with severe middle cerebral artery stenosis or occlusion and 10 healthy volunteers. The regions of interest (ROI) were put on the affected hemisphere of the MCA blood supply area and the contralateral side in both groups. The relative cerebral blood volume (rCBV), relative mean transit time (rMTT), relative cerebral blood flow (rCBF) and CVR were measured.Results① The rCBV, rCBF and rMTT of the affected side were 149.16±33.01, 18.04±5.24, 8.65±1.81 before CO2 inhalation stress, and 156.23±21.60, 23.77±8.77, 8.72±3.01 after CO2 inhalation stress. The rCBV, rCBF and rMTT were signiifcantly increased (t=1.238, 2.561 and 2.647, P<0.05) after CO2 inhalation stress. The rCBV, rCBF and rMTT of the contralateral side were 176.22±40.12, 22.43±5.74, 8.10±3.71 before CO2 inhalation stress, and 198.54±39.87, 27.64±7.22, 8.03±2.97 after CO2 inhalation. The rCBV, rCBF was significantly increased (t=1.780 and 1.665,P<0.05) while rMTT was signiifcantly decreased (t=2.871,P<0.05) after CO2 inhalation.②The CVR of the affected side, contralateral side and control group were 18.9%, 26.8%, and 39.1%, respectively. There were significantly differences (t=1.604, 2.321 and 1.874,P<0.05) between the affected and contralateral side, the affected side and control group, the contralateral side and control group.ConclusionPWI with CO2 inhalation stress test is valuable in assessing the cerebrovascular reserve in patients with severe middle cerebral artery stenosis or occlusion.

Objective To compare short-term therapeutic outcomes and the safety of percutane-ous radiofrequency ablation (PRFA) with left single lung ventilation (LSLV) for liver cancer of the hepatic dome (LCHD) and that of PRFA for right liver carcinoma in favorable location. Methods Thirty one patients with hepatocellular carcinoma (belonging to LCHD) receiving PRFA with LSLV (Group LCHD) between January 2006 and January 2009 in our hospital were selected, and 45 control patients with right lobe HCC ≥1 cm away from the liver capsule, gallbladder, and main portal bran-ches were also included. One month after PRFA, residual tumors were followed up with contrast en-hanced CT and alpha fetal protein and PRFA was repeated in the presence of residual foci. Tumor-free survival time was defined as the duration from complete ablation to diagnosed local tumor progression.The Mann-Whitney test was used to compare age, tumor diameter, and average number of punctures between LCHD patients and controls. A χ2 test was used for comparison of the incidence of complica-tions and incomplete tumor ablation rate. The Kaplan-Meier's method was used for calculation of local tumor-free survival rate compared with a log-rank test. Results The incidence of right shoulder pain was significantly higher in LCHD patients than in controls (87. 1% vs 11. 1%, P<0. 01). LCHD pa-tients showed no difference from controls in the average number of punctures (2. 8±. 5 vs 3. 2±. 5,P>0. 05). Meanwhile, there was no difference between the 2 groups in average duration of treatment and hospitalization, and the complete tumor ablation rate at first PRFA. No differences were observed in the 1-, 2- and 3-year local tumor-free survival rates between LCHD patients (85. 5% , 65. 8% , and 36. 4% ,respectively) and controls (87.7%, 62. 3% , and 34.0% , respectively). Conclusion PRFA with LSLV for LCHD seems to promise comparable short-term outcomes and safety to PRFA for right liver carcinoma of fa-vorable location and should be preferred as one of the therapeutic options for LCHD patients with tumor di-ameters≤5 cm regardless of its unique location.

Objective To assess the therapeutic efficacy and safety of CT-guided percutaneous radiofrequency ablation(PRFA) for hepatocellular carcinoma in the bare area (HCCBA). Methods During the period from April 2000 to June 2009, 26 patients with HCCBA were treated with CTguided PRFA, and 26 other HCC patients were selected as controls, whose lesions were located in the right lobe ≥1.0 cm away from the liver capsule, gallbladder, and main portal branches. One month after PRFA, the residual tumors of each patient were examined by contrast-enhanced CT and alpha-fetoprotein test, and repeated PRFA was undertaken if residual was present. Tumor-free survival was defined as the duration from complete ablation to diagnosed local recurrence. The 2-independent-samples t-test was used to compare tumor diameter between HCCBA patients and controls. The MannWhitney U test was used to compare patient's age, etiologies of liver disease, liver function status,number of needle punctures and the value of AFP. A χ2 test was used for comparison of the complete tumor ablation rate and the cumulative local tumor-free survival rate. Results No significant difference was observed in the incidence of complication between the HCCBA patients and the controls (26. 9% vs 19.2%,P＞0.05). There were no differences between the two groups in the number of needle punctures and the complete tumor ablation rate at first PRFA. Furthermore, no differences were observed in the cumulative 1-,3- and 5-year local tumor-free survival rates between HCCBA patients (88. 5%, 46.2% and 19. 2% respectively) and patients in the control group (92.3%, 53.8% and 15.4% respectively). Conclusion CT-guided PRFA is effective and safe for HCCBA and could be preferred as one therapeutic option for HCCBA.

Purpose To explore the value of diffusion weighted imaging monoexponential and biexponential modelsin differentiating benign and malignant solitary pulmonary tumors.Materials and Methods Seventy-seven patients with pathologically confirmed solitary pulmonary tumors were enrolled in this study,a total of 96 lesions were studied,48 benign ones and 48 lung cancers (LC),including 19 cases of squamous cell carcinomas (SCC) and 28 cases of adenocarcinomas (Adeno-Ca).Apparent diffusion coefficient (ADC),slowapparentdiffusion coefficient (Dslow),fast apparentdiffusion coefficient (Dfast) and fast diffusion ratio (f) were calculated with monoexponential and biexponential models for all the pulmonary tumors.Results The ADC and Dslow values of benign masses [ADC (1.37 ± 0.48)× 10-3 mm2/s;Dslow (1.34 ± 0.45)× 10-3 mm2/s] were both significantly higher than those of Adeno-Ca [ADC (1.19±0.23)×10-3 mm2/s;Dslow (1.12±0.35)×10-3 mm2/s] and SCC [ADC (1.13±0.28)×10-3 mm2/s;Dslow (1.02 ± 0.32)× 10-3 mm2/s].There was no significant difference in ADC and Dslow values between Adeno-Ca and SCC (P＞0.05).The Dfast and f values of malignant masses were higher than benign ones,but the difference was not statistically significant (P＞0.05).Dslow were both significantly higher in accuracy (72.2％) and sensitivity (91.3％) than other imaging indicators (accuracy:55.5％-68.0％;sensitivity:41.3％-78.3％;all P＜0.01) in discriminating LC from benign masses showed by receiver operating characteristic curve analysis.Conclusion DWI biexponential model-derived Dslow shows greater accuracy than ADC in differentiating benign and malignant solitary pulmonary lesions.