Background and purpose:Primary thyroid lymphoma (PTL) is uncommon in clinic with quite different treatment from that of other malignant thyroid tumors. Therefore, to achieve complete understanding of PTL has crucial signiifcance. This study aimed to investigate the clinical and computed tomography (CT) characteristics of PTL.Methods:The clinical and imaging data from 22 patients with PTLs conifrmed by pathology were collected. The clinical symptoms of patients, the site, size, shape, margin, CT value and enhancement pattern, relation with surround-ing tissues of PTLs and cervical lymph nodes were summarized retrospectively.Results:All the 22 patients including 8 males and 14 females had an average age of 60 years (range: 39-77 years). Twelve PTLs rapidly progressed in short term and the rest expanded slowly. The tumors involved bilateral thyroid in 11 cases, unilateral thyroid in 8 cases and both right lobe and isthmus in the remaining 3 cases. The long and short ranges were (12-104) mm and (11-71) mm. The solitary, multiple and diffuse nodules distributed in 5, 5 and 12 patients, respectively. In axial plain CT scans, low density appeared in 15 patients, isodensity in 7 patients, calciifcation inside the lesion in 0 patient, and necrosis in 5 patients. Nineteen PTLs manifested slight or moderate enhancement, and 3 marked enhancement in contrast-enhanced axial CT images. Homogeneous density and mixed density were demonstrated in 13 and 9 cases, respectively. Trachea and esophagus was pushed in 17 and 5 cases, tumors were involved into superior mediastinum in 12 cases and enlarged lymph nodes were demonstrated in 8 cases.Conclusion:If a solid thyroidal mass in an old female patient rapidly pro-gresses in short term and CT scans show homogeneous and low density, slight or moderate enhancement, and diffusive swelling with compression and invasion of surrounding tissues, it has a high possibility of PTL.

Purpose:To investigate the detection ability of CT and MRI in skull base invasion in nasopharyngeal carcinoma. Methods:Sixty patients with nasopharyngeal carcinoma were examined by plain CT scan at axial sections and MRI of T_(1)WI at axial , coronal and sagittal sections and T_(2)WI at axial sections fast spin echo (FSE). Results:The overall positive rates of skull base invasion detected by CT and MRI were 16.7% and 53.3%(?~2 Test,P

Purpose:To investigate the values of three newer contrast enhanced MRI sequences including gadolinium-enhanced FLAIR MRI(CE FLAIR), dynamic contrast-enhanced MRI (DCE MRI) and perfusion- weighted MRI(PWI) by comparing their advantages and disadvantages respectively in the diagnosis of intracranial tumors. Methods:43 patients with intracranial tumors underwent DCE MRI, CE FLAIR and PWI respectively. The gadolinium-enhanced FLAIR, dynamic enhanced MR and perfusion-weighted MR images were evaluated independently by two radiologists for the number of examinations with one or more enhancing lesions, the number and location of enhancing lesions per examination, the detectability for different lesions in different locations, size and extent of the lesions. Results:Perfusion-weighted MR images showed poor quality and could not give a diagnosis in 5 of 43 cases because of heavy susceptibility artifacts. There were 47 lesions in the 38 cases. However, 41 lesions were found on CE FLAIR MR images and 42 on DCE MRI and 45 on PWI. 3 lesions(2 located in the subcortical area and 1 in paraventricle) were only revealed on the CE FLAIR images. 4 lesions in the basal ganglia area were only found on dynamic enhanced images. 7 lesions in the cerebral hemisphere were only found on perfusion-weighted images. So there were significant differences in revealing lesions of different locations with the three MR modalities(P

Background and purpose:Parotid gland is rich in fat and has obvious contrast with bone and muscle in CT image.The preoperative examination of CT could help to evaluate the scale of tumor invasion and the relationship between tumor and normal tissues so that the proper therapy could be properly designed.The purpose of this study was to evaluate the roles of computer tomography(CT)in differential diagnosis of benign and malignant parotid tumors and to improve the diagnostic accuracy.Methods:CT images of 17 patients with benign parotid tumors and 15 patients with malignant parotid tumors proved by pathology were analyzed retrospectively.All patients underwent CT contrast-enhanced examination preoperatively.Images of all patients were retrospectively reviewed by two experienced radiologists in the diagnosis of head and neck tumors.Results:14 of 17 cases of benign tumors had round shapes and 9 of 15 cases of malignant tumors exhibited lobular or irregular masses(P

Objective To observe the findings of 1H magnetic resonance spectroscopy ( 1H MRS) and explore its value for diagnosis of radiation induced-temporal lobe necrosis in nasopharyngeal carcinoma (NPC). Methods Thirteen patients with definite clinical diagnosis of radiation induced temporal lobe necrosis in NPC underwent 1H MRS. All 1H MRS examinations were performed on a Singa Horizont 1.5 T whole body MR system with point resolved spectroscopy (PRESS) and chemical-shift selective saturation (CHESS) (TR=2000?ms,TE=144 ?ms). The voxel (2?cm ? 2?cm ? 2?cm) was positioned in both of the lesion and the contralateral side of the temporal lobe as the control (except for bilateral lesions). 2THZ]Results The interval between radiation and the examination ranged from 32 to 172 months ( median, 42 months). Eighteen lesions were observed in 13 patients (5 patients with bilateral lesions). 1H MRS was performed on 17 lesions and 8 control temporal lobes. The mean values of NAA/ Cr in the lesions and the control temporal lobes were 1.33?0.28、1.78?0.34 respectively(t=3.22, P=0.005). Three lesions showed NAA、Cho and Cr peak absent (2 lesions with Lip peak ). Among 8 patients with the control temporal lobes 1H MRS examined, Cho/Cr decreased in 6 patients (75%). Four lesions showed Lip , Lac and MI, respectively. Conclusions The radiation-induced temporal lobe necrosis shows abnormal features on 1H MRS. Significant decrease of NAA/ Cr as well as Cho/Cr are observed in most patients. 1H MRS may play a role in the diagnosis of radiation induced temporal lobe necrosis.

Objective To investigate the effect and implying mechanism of continuous veno-venous hemofiltration(CVVH) on endoplasmic reticulum stress(ERS) and apoptosis of HUVEC cells which induced by serum of patients with multiple organ dysfunction syndrome(MODS).Methods Ten patients with MODS who received CVVH and 10 healthy volunteers were involved in this study.This experiment was divided into 4 groups: healthy control,group of pre-CVVH,group of 6-hour-CVVH and group of 20-hour-CVVH.Serum of healthy volunteers and the sera of patients with MODS at pre-CVVH,6-hour-CVVH and 20-hour-CVVH were used to induced HUVEC cells respectively in vitro for 24 h.The cell apoptosis was examined by TUNEL assay,the intracellular GRP78 protein was observed by immunocytochemistry,and the mRNA expressions of GRP78,CHOP,TNF-?,and IL-6 in the cells were measured by RT-PCR.The levels of serum SOD and MDA were detected by colorimetric method,and those of of TNF-? and IL-6 of by ELISA.Results Compared with healthy control,the group of pre-CVVH showed higher cellular apoptosis rate(P

Objective To compare the treatment effectiveness of AO/ASIF proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA) in treatment of intertrochanterie fractures. Methods A retrospective study was done on 233 patients with intertroehanteric fractures treated from August 2004 to December 2006. The patients were divided into PFN group (188 patients) and PFNA group (45 patients) for comparing operative procedures and postoperative functional recovery. Results There was statistical difference in aspects of incision length, blood loss and operation time between two groups. The follow-up for 22.8 months showed excellence rate of 89.9% in PFN group and 91.1% in PFNA group, with statistical difference (X2 = 0.06, P > 0.05). There occurred hip varus in one patient and antirotation nail cutting-out in two in PFN group, which was not found in PFNA group. Conclusion PFN and PFNA are both good choices for treatment of intertrochanteric fractures. Compared with PFN, PFNA has more advantages in reducing operation time and blood loss especially for the eider patients with osteoporosis.

Objective To explore the role of phospholipase A2 receptor 1 (PLA2R1) in the diagnosis,differential diagnosis and evaluation of idiopathic membranous nephropathy (IMN) in adult patients.Methods A total of 242 renal disease patients diagnosed by renal biopsy from March 2015 to January 2016 were enrolled,consisting of 90 IMN,20 secondary membranous nephropathy (SMN),82 IgA nephropathy (IgAN),30 minimal changed disease (MCD),16 focal segmental glomerulosclerosis (FSGS) and 4 membranoproliferative glomerulonephritis (MPGN).Their clinical data including age,sex,serum creatinine (Scr),serum albumin and 24 h urinary protein were collected.Serum PLA2R1 was measured by enzyme linked immunosorbent assay.PLA2R and IgG subclasses in glomeruli were detected by indirect immunofluorescence assay.The positive rate of serum PLA2R1 among those groups and its correlation with clinical-pathological parameters were analyzed.Results Compared with IMN patients,SMN,MCD and FSGS patients were younger (all P ＜ 0.01); IgAN patients were younger and had higher serum albumin and lower 24 h proteinuria (all P ＜ 0.001); MPGN patients had higher Scr (all P ＜ 0.01).The positive rate of serum PLA2R1 was 75.6％ in IMN patients,while it was 0.0％ in non-IMN patients.The distribution between serum PLA2R1 and pathological diagnosis had difference (P ＜ 0.001),their positive coincidence rate was 100％,negative coincidence rate was 87.4％,total coincidence rate was 90.9％ and their consistency was well (Kappa=0.795,P ＜ 0.001).Among IgG subtype comparisons between IMN patients and SMN patients in the glomeruli,only moderate or more positive IgG4 had statistical differences (82.2％ vs 5.0％,P ＜ 0.001); the positive rate of glomerular PLA2R1 was 41.1％ in IMN patients,higher than 10.0％ in SMN patients (P=0.009); positive PLA2R1 with moderate or more positive IgG4 in glomeruli in IMN patients was more than that in SMN patients (40.0％ vs 0.0％,P ＜ 0.001),which could improve the diagnostic specificity of IMN.In IMN patients serum PLA2R1 and glomerular PLA2R1 had statistical differences (P＜0.001).Spearman rank correlation analysis showed that serum PLA2R1 of IMN patients positively correlated with 24 h proteinuria (r=0.315,P=0.002),negatively correlated with serum albumin (r=-0.228,P=0.030) and didn't correlate with Scr (r=0.199,P=0.059).Conclusions Serum PLA2R can be used as the specific indicator for diagnosis,differential diagnosis of IMN and to reflect the severity of IMN in patients.

Objective To evaluate the clinical use of delayed open reduction and internal fixation technique in the treatment of Rud?i Ⅲ Pilon fractures. Methods From May 1997 to June 2003, 38 patients with Rud?i Ⅲ Pilon fractures underwent immediate calcaneal traction as well as treatment with methylprednisolone and mannitol. After 5-8 days, all patients underwent regular open reduction and internal fixation with cloverleaf buttress plates. One week after the operation, ankle joint began to exercise with no weight bearing. Results All patients were followed up for average 18 months and evaluated subjectively and objectively by using systems of Teeny and Wiss, which showed good results for 74 %, mild for 21% and poor for 5%. All fractures healed within an average of 5.7 months except for two cases of infections and one soft tissue complication. Conclusion Delayed open reduction and internal fixation offers acceptable way for treatment of severe Pilon fractures.

Objective To observe whether bone marrow mesenchymal stem cells (MSCs) can promote the repair of IgA nephropathy and to explore its possible mechanism. Methods Sprague-Dawley rats were randomly divided into three groups which were MSCs injection group, normal saline(NS) infusion group and healthy control group. IgA nephropathy model was established by the improving method with BSA +SEB +CCl4 in former two groups. MSCs of SD rats were continuously cultured in vitro and identified with specific surface antigens by flow cytometry and osteogenic and adipogenic differentiation. MSCs were labeled with bromodeoxyuridine (BrdU) in vitro before transplanted. At 1st and 4th week after MSCs injection, the changes of body weight, urine protein, renal function, histopathology and IgA immunofluorescence were observed. MCP-1, TGF-β1 in urine were detected by ELISA. The expression of MCP-1, TGF-β1 in kidney were examined by RT-PCR. The cytokines and BrdU labeled MSCs were detected by immunohistochemistry to observe the disposition in kidney. Results At the end of the first week of MSCs transplantation, MSCs group urine protein (36.86±4.78) mg/24 h, serum creatinine (53.50±6.28) μmol/L, and the NS group urine protein (66.98±5.86) mg/24 h, serum creatinine (82.50±8.36) μmol/L, the differences between two groups were significant (P<0.05). At the same time, the content of MCP-1, TGF-β1 in urine and expression in renal tissue of MSCs group were obviously less than those of NS group (P <0.05). At the end of the 4th week, the body weight, histopatholngy, IgA immunofluorescence of MSCs group were remarkably improved as compared with those of NS group. The content of MCP-1, TGF-β1 in urine and expression in renal tissue, and renal pathological change in MSCs group had no significant differences as compared with those of healthy control group. As the time passed, the disposition of BrdU-labeled MSCs in kidney was taper. Conclusions MSCs injection contributes to renal repair in rat IgA nephropathy. The mechanism may partly depend on adjusting the excretion of cytokines in renal microenvironment and/or other functions rather than completely depend on their differentiation to renal cells.