Objective To investigate the CT and MRI features of the hemangiopericytoma (HPC) in central nervous system(CNS) and improve its diagnostic accuracy. Methods The CT and MRI features of the HPC in CNS proved by operation and pathology were retrospectively analyzed and the criteria of diagnosis and differential diagnosis were summarized.Results 7 of 9 cases were intracranial and 2 were intraspinal. The lesions appeared homogeneous high density in 4 cases on plain CT scans and 3 cases appeared inhomogeneous density, 4 cases appeared isointense with cortical gray matter on both T_1-weighted and T_2-weighted images, 3 cases were heterogeneous. All contrast-enhanced scans showed marked enhancement.Conclusion The accuracy diagnosis of HPC in CNS can be made by CT and MRI.

Objective To discuss CT,MR and~1H-MRS features of central neurocytoma(CNC).Methods Imaging findings ofneurocytomas in 7 cases confirmed by pathology were retrospectively analyzed with literature review.2 cases were examined by CT、MR and~1 H-MRS,2 cases only by MR,and 3 cases only by CT.Results All the tumors were located in the lateral ventricles.There were different degree hydrocephalus in all cases.The masses were heterogeneous appearance on CT with necrotic area and fine to course calcifications.Heterogeneous enhancement was seen in the solid portion.The tumors were isointense and hypointense on T_1WI and heterogeneous on T_2WI.Heterogeneous enhancement was also seen on MRI.The in vivo~1H-MRS showed prominent choline(Cho) and low N-acetyl aspartate(NAA) compared to the normal.Conclusion Central neurocytoma should be considered when a tumor was located at the lateral ventricles especially septum pellucidum in young patients.CT,MR and~1H-MRS are helpful in making a preoperative diagnosis.

Objective To investigate the diagnostic value of 1H magnetic resonance spectroscopy (1H-MRS) in mammary tumors and to discuss the technique factors which influence the detection rate.Methods The 1H-MRS features of 47 mammary tumors, of which 24 malignant tumors and 23 benign tumors confirmed by pathology were analyzed. All of the tumors were detected before Gd-DTPA enhancement. Results Eleven of 24 malignant tumors showed increased choline resonance peak at 3.24 ppm while 4 of 23 benign ones at 3.24 ppm .The positive value were 45.8% and 17.4% respectively. The sensitivity and specificity were 45.8% and 82.6% respectively by using 1H-MRS to discriminate benign from malignant tumors. The main factors influencing the detection rate were low suppressed lipid, low suppressed water and low single-noise rate.Conclusion Choline is not special features of malignant tumors. Choline can be obtained despite the nature of tumor if they grow rapidly. The low sensitivity of choline to be detected mainly dues to technique factors.

Objective To explore the feasibility of building tissue engineered cartilage by bone marrow stromal cells and pbotografting modified copolymers of 3-hydroxybutymte and 3-hydroxyvalerate.Methods Sheep BMSCs were seeded in three-dimensional photografting modified PHBV scaffoids.Twenty-four hours later.composites were cultured with ehondrogenically inductive medium(DMEM)containing TGF-B(10 ng/m1),IGF-1(150 ng/m1)and 20% fetal bovine serum.Three weeks later,the constructs were evaluated by scanning electron microscopy(SEM)and light microscopy with alcian blue,safrine 0 and type Ⅱ collage immunohistochemical staining.GAG contents of constructs were determined by DMB(1,9-dimethylmethylene blue)binding assay at weekly intervals up to 3 weeks.The composites were implanted subcutaneously in sheep abedoml and were evaluated macroscopically and bistologically at 4 weeks postoperatively.Results SEM photograph showed.after one week culture,cell morphology changed from fibroblast-like elongated spindle to the flat rounded like chondrocytes,and the extra cellular matrix also increased obviousl~.Furthmore,with the culture time extension,this change were more evident.HE staining showed that cells filled all the inter-connected pores in the constructs.And more cells were observed in the outer layer of the constructs.ECM(extraeellular matrix)Was strongly positive by Aleian blue,Safrine O staining and type Ⅱ collage immunohistechemical staining.DMB binding assay revealed that the induced BMSCs GAG secretion(1306.7±192.3)wag significantly higher than BMSCs(205.0±26.2)(P<0.001),but it was significantly lower than passage 2 ehondrocytes(1969.2±235.3)(P<0.001).Saltine O and type Ⅱ collage immunohistochemical staining were positive in constructs implanted subcutaneously.Conclusion Tissue engineered cartilage could be obtained using BMSCs and photografting modified PHBV,but there are still gaps physiologically between the constructs and the nature cartilage.

Objective To evaluate the effects of conscious sedation analgesia during superficial bladder tumor resection for elderly patients. Methods Forty elderly patients who needed 2 μm laser resection for bladder tumors were treated with target controlled infusion (TCI) remifentanil and propofol. The initial target concentration of remifentanil was 2.5 ng/mL and that of propofol was 1 μg/mL. The target concentration of those two agents was adjusted until loss of painfulness to the operative stimulus. The MAP, HR, SpO2, RR and PetCO2, BIS and scores by OAA/S were compared between pre-and post-surgery at different time points (time before anesthesia, T0; time before analgesia, T1; time when the resection began, T2; 5 minutes after the resection began, T3;10 minutes after the resection began, T4; 15 minutes after the resection began, T5; the end of operation, T6;5 minutes after operation). Results All patients lived through the surgery under a conscious sedation. After the anesthesia, blood pressure, heart rate and breathing rate were declined, while oxygen saturation was unchanged. Conclusion TCI with remifentanil and propofol provides better hemodynamic stability, satisfactory sedation analgesia and faster recovery of surgery.

Objective To investigate the value of apparent diffusion coefficient (ADC) of diffusion-weighted magnetic resonance imaging (DW-MRI) in distinguishing benign from malignant breast lesions. Methods ADC in 26 normal breasts, 24 malignant breast lesions, and 30 benign breast lesions confirmed by operation and pathology were calculated, respectively, and their differentiations in statistics were compared. The differentiations of different ADCs (b=1000-0, 500-0, 1000-500 s/mm2) were also compared. EPI (TR 2900 ms, TE 84 ms, thickness 5 mm) was used in order to acquire the imaging. Results There were significant differences among the ADC values of normal breast tissue, benign, and malignant lesions. The ADC of malignant lesions was lower than those of normal breast tissue and benign lesions, and the ADC of benign lesions was lower than that of normal breast tissue. There were significant differences among the ADC value of b=1000-0, 1000-500, and 500-0 s/mm2. The lower the b value, the higher the ADC. The sensitivity and specificity of ADC for the diagnosis of malignant lesion were 64% and 96.7% if the upper bound of 95% confidence interval was set as a differential level. Conclusion The differentiation of benign from malignant breast lesions by ADC is applicable, although the sensitivity is low, the specificity is high.

Objective To investigate the differences of apparent diffusion coefficient(ADC)value in normal breasts and to evaluate the correlation between ADC value and corresponding histology.Methods Sixty-two normal breasts including 42 normal breasts of 42 patients with unilateral lesions and 20 normal breasts of 10 volunteers were studied.The ADC value of all 62 normal breasts were calculated when b value was given from 1000 to 0 s/mm~2,1000 to 500 s/mm~2and 500 to 0 s/mm~2.The MRI features of 60 normal breasts were classified into 3 types(dense,lobular-speckled,degenerative types)according to Wolf's classification and histology.Results DWI and ADC images were different in 3 types of normal breasts because of different histologic structures.The mean ADC value of the dense type breasts was(1.70? 0.37)?10~(-3)mm~2/s,the lobular-speckled type was(1.93?0.46)?10~(-3)mm~2/s and the degenerative type was(1.18?0.65)?10~(-3)mm~2/s(F=12.998,P=0.000).There were no significant differences between the dense type and the lobular-speckled type(F=2.167,P=0.147),but significant differences between the dense type and the degenerative type,the lobular-speckled type and the degenerate type(F=5.593 and 19.128;P=0.029 and 0.000).When b value decreased,the ADC value of the dense type and the lobular- speckled type increased correspondingly,but the degenerative type didn't increase apparently.Conclusion ADC value was influenced by histologic structures in normal breasts and also was influenced by b value in the dense type and lobular-speckled type breasts.

Objective To investigate the diagnostic value of internal septation for differentiating benign from malignant breast lesions.Methods A total of 26 patients were included in the study,in which 12 patients had 20 lesions of breast carcinoma and 14 patients had 25 lesions of fibroadenoma diagnosed either pathologically or clinically.The differential diagnoistic value of the hypointensive internal septation was analyzed.Results The signal intensity of fibroadenomas and malignant lesions on T_2-weighted fat- suppressed images could be classified as iso- to hyper- intensity,hypointensity and mixed intensity. According to the signal intensity classification,there were 5,11 and 4 cases in patients with breast carcinoma respectively,while 11,10,4 cases in patients with fibroadenoma respectively.There was no statistical difference in the distribution between the two patient groups(?~2=1.764,P=0.414).The shape of fibroadenomas and malignant lesions could be classified as irregular、roundish or lobulated.According to the morphological classification,there were 12,7 and 1 case in patients with breast carcinoma respectively, while 1,7,17 cases in patients with fibroadenoma respectively.There was statistical difference in the distribution between the two patient groups(?~2=23.262,P=0.000).The typical features of fibroadenomas were as follows:lobulated shape,hypointensive internal septations on T_2-weighted or postcontrast images. The diagnostic sensitivity of the three imaging features for fibroadenoma was 68%(17/25),52%(13/25), and 72%(18/25)respectively;and the diagnostic specificity was 95%(19/20),90%(18/20),95% (19/20)respectively.Conclusion The internal septation is a rather specific sign for diagnosis of fibroadenomas.

Objective:To review the treatment of life threatening head and neck space infection.Methods:Retrospective was con-ducted to analyse the patient characterization,signs and symptoms at the time of presentation,presence of concomitant systemic co-morbidities,treatment,prognosis and bacteriology.Results:32 patients from 2007.01 to 2013.01(mean age was 57.71 years)were included.The cases were increased year by year.1 1 (34.37%)patients had breathing difficulty requiring tracheostomy and 19 (59.3%)had concomitant systemic comorbidities.23 cases recovered completely,8 with severe mediastinal infection were trans-ferred to the department of thoracic surgery or the department of respiratory medicine.1 patient died.Pus submission rate was 96.87%,the bacteria detection rate was 37.50%.Pus culture showed mixed infection dominated by streptococci.Staphylococcus au-reus,pseudomonas aeruginosa,enterococcus faecalis,prevotella and neisseria were detected.Conclusion:Annually incidence of life threatening head and neck space infection is increasing.Treatment of the infection should include:①Ensuring the airway patency;②Surgical incision and drainage as early as possible;③ Hypoglycemic control,maintenance of hemodynamic,nutritional support,and multi-disciplinary approach are the key points in the management of such infections;④ Systemic antibiotics.

Objective To detect the expressions of apoptosis-related factors and inflammatory cytokines in superficial and deep layers of as well as anagen hair follicles in lesions of early alopecia areata (AA).Methods Scalp biopsy samples were collected from 25 patients with early AA and 15 healthy human controls.Fluorescence-based quantitative PCR was performed to detect mRNA expressions of apoptosis-related genes p53,caspase 3,Fas,survivin and bcl-2,as well as those of inflammatory cytokines interleukin (IL)-4,IL-10,IL-12 and interferon (IFN)-γ.An immunohistochemical assay was conducted to measure the expression of p53 protein in anagen hair follicles.Results Compared with control skin samples,anagen hair follicles in AA lesions showed significantly increased mRNA expression levels (expressed as 2-△△Ct) of pro-apoptotic factors caspase 3,p53 and Fas (6.78,8.01,9.74,respectively,all P ＜ 0.05),but decreased mRNA expression levels of antiapoptotic factors bcl-2 and survivin (0.08 and 0.03 respectively,both P ＜ 0.01),and similar mRNA expression levels of inflammatory cytokines.There was a significant increase in mRNA expression levels of Th1 cytokines IFN-γ and IL-12 (2.75 vs.1.00,P ＜ 0.05; 85.67 vs.1.00,P ＜ 0.01),but a significant decrease in the expression level of the Th2 cytokine IL-10 (0.002 vs.1.000,P ＜ 0.01) in superficial layers of AA lesions compared with those of normal control skin.The degree of changes in mRNA expression levels of IL-10 and IL-12 was significantly higher in superficial layers than in deep layers of AA lesions (P＜0.01 and 0.05 respectively).The immunohistochemical assay showed that the number of p53-positive cells per 100 cells in anagen hair follicles of AA lesions was higher than that in those of control skin (t =23.79,P ＜ 0.01).Conclusions Anagen hair follicles in AA lesions exhibit high expressions of pro-apoptosis factors,but low expressions of antiapoptotic factors,suggesting that apoptotic factors play a role in the occurrence of AA.