Objective Mediastinal primary small cell neuroendocrine carcinoma ( MPSCNC) is a rare neoplasm of high ma-lignant potential mostly affecting elderly and middle-aged males, which has a high rate of misdiagnosis because of its unidentified histo-genesis and lack of obvious characteristic imaging findings .This study was to investigate the CT findings and pathologic features of MP-SCNC, so as to improve the recognition and diagnostic accuracy of the disease . Methods We retrospectively analyzed the imaging and clinicopathologic data about 4 cases of pathologically confirmed MPSCNC and reviewed relevant literature . Results Of the 4 tumors, 2 were located in the anterior-middle-superior mediastinum , 1 in the anterior-superior mediastinum , and the other in the mid-dle-superior mediastinum .Three of them exhibited irregular shape , unclear boundary , and inhomogeneous density , with low-density cyst degeneration and necrosis , of which two had scattered punctate calcifications .Enhanced scanning revealed moderate uneven en-hancement in 3 cases and ring-shaped enhancement the other .Pathological findings showed small tumor cells with marked pleomor-phism, little cytoplasm, pale chromatin, inconspicuous or absent nucleoli , and obvious mitotic figures.Immunochemistry manifested positive CgA, Syn, and CK in all the 4 cases, positive NSE, CD56, and Ki-67 in 3 cases, and positive epithelial membrane antigen in 1. Conclusion A tumor located in the anterior-middle mediastinum with scattered punctate calcifications and compressing or inva-ding the adjacent mediastinal structures should be suspected as a small cell neuroendocrine carcinoma . However , definite diagnosis should be based on histopathologic and immunohistochemical exami-nations .

Objective To investigate the MSCT imaging of anterior mediastinal primary malignant tumors , and to improve the accuracy of diagnosis. Methods The imaging and clinical data of forty-five patients with anterior mediastinal primary malignant tumors were retrospectively analyzed. Results Among all forty-five cases, there were seventeen thymic carcinomas , and cystic and necrotic earas were seen in all cases. Fourteen were malignant lymphomas with a single irregular soft tissue mass or multiple merged nodules. There were enlarge lymph nodes around the tumors and (or) in other parts of the body. Twelve cases were malignant germinomas, the levels of rinary human chorionic gonadotropin (HCG) or blood armour fetuin (AFP) were abnormal in ten cases, and calcifications were seen in four cases and fat composition was observed in three cases. One malignant solitary fibrous tumor was observed on the left side of the anterior-superior mediastinum with cystic degeneration and necrosis. One was neuroendocrine carcinoma with clear boundary , cystic degeneration and necrosis , after enhanced scanning , it showed ring-shaped reinforcement. Conclusion Anterior mediastinal primary malignant tumors have certain characteristics of MSCT findings , in combination with clinical information , which can help the diagnosis and efficacy evaluation.

Objective To explore the imaging radiological and clinicopathological characteristics of benign fibrous histiocytoma (BFH) of bone, in order to improve the imaging diagnostic accuracy of the disease Methods Radiological and clinical data of 16 patients with BFH confirmedbypathology were retrospectively analyzed , and relevant literatures were reviewed. Results The X-ray findings of 14 BFHpatients were osteolytic lesion , expansive destruction of bone,without soft tissue involvement, 10 with residual apophysis,9 with osteosclerosis marginal; CT was performed on 2 patients. Expansive destruction of bone and soft tissue densities were seen inside the loops , 1 case remarkable enhancement of the lesion. MRI was performed on 9 patients and 5 cases showed long T1 and T2 signal intensity; 1case showed equal T1 and long T2 signal intensity in cystic part and equal T1 and T2 signal intensity in the solid part. One patient had pathological fracture, and the surrounding soft tissue invaded, showing equal T1 and long T2 signal intensity. Two lesions located at spinous process of cervical vertebra , showing long T1 short T2 and equal T1 and T2 signal intensity. Linear low signal separation shadow in T1 and T2 could be seen in 6 cases. Long T1 and short T2 sclerotic ring were seen in 4 cases. Solid part of tumor and linear separator were obviously enhanced. Conclusions The radiological findings of benign fibrous histioeytoma of bone indicate some characteristics. The combination with X-ray , CT and MRI examination is helpful to improve the diagnostic accuracy of the disease before operation.

Objective To investigate the effect of dexmedetomidine on the stress responses during wakeup test in patients undergoing cerebral functional area operation performed under propofol combined with remifentanil anesthesia.Methods Thirty-six ASA physical status Ⅰ or Ⅱ patients,undergoing cerebral functional area operation requiring wake-up test,aged 18-60 yr,weighing 50-70kg,were randomly divided into control group (group C) or dexmedetomidine group (group D) with 18 cases in each group.Dexmedetomidine 0.8 μg/kg was infused over 10 min before induction of anesthesia followed by infusion at 0.4 μg·kg-1 · h-1 in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with target-controlled infusion of propofol and remifentanil and iv injection of cisatracurium.At 30 min prior to wake-up test,target-controlled infusion of propofol and application of mulscle relaxants were stopped,the target plasma concentration of remifentanil was decreased to 1 ng/ml,and in group D the infusion rate of dexmedetomidine was decreased to 0.1 μg·kg 1· h-1.Anesthesia time and consumption of anesthetics before wake-up test,wake-up time,and development of complications and intraoperative awareness during wake-up test were recorded.At 30 min prior to wake-up test (T1),immediately after wake-up (T2),at 5 min after wake-up (T3),and at 10 min after the anesthetic depth was deepened (T4),HR,mean arterial pressure and BIS value were recorded and blood samples were taken for determination of plasma concentrations of epinephrine (E) and norepinephrine (NE).Results Compared with group C,the consumption of propofol and remifentanil was significantly reduced before wake-up,the incidence of hypertension was decreased during wake-up test,and HR and plasma E and NE concentrations were decreased at each time point (P ＜ 0.05),and no significant difference in mean arterial pressure and BIS value was found in group D (P ＞ 0.05).Tachycardia,restlessness,bucking and awareness were not observed during wake-up test in group D.Conclusion Dexmedetomidine can inhibit the stress responses during wake-up test and raise the quality of wake-up test in patients undergoing cerebral functional area operation performed under propofol combined with remifentanil anesthesia.

Objective To observe the in vitro inhibitory effects of brucea javanica oil on human washed platelet and explore the possible mechanism.Methods Human washed platelets were mixed withdifferent concentration of brucea javanica oil which were divided into four groups[untreated control group,negative control group,9.0% of brucea javanica oil group,and 22.5%of brueea javanica oil group].The maximal ratio of platelet aggregation induced by adenosine liphosphate(ADP),arachidonic acid(AA),collagen,and thrombin,respectively,was measured with platelet aggregation analyzer.The expressions of fibrinogen receptor(FIB-R)and P-selectin(CD_(62p))on external membrane of activated platelet were determinated with flow cytometry.The F-actin of cytoskeletal structure in activated platelet was detected by SDS-PAGE.Results At 9.0% of brucea javanica oil,the maximal ratio of platelet aggregation[(57.7±4.0)%,(62.2±3.9)%,(66.9±5.0)%and(71.8±5.1)%]induced by ADP,AA,collagen,and thrombin,was significantly lower than that[(75.3±4.1)%,(79.3±4.8)%,(80.6±5.4)%,(84.1±6.2)%]at negative control(0% of brucea javanica oil)(P<0.01),but makedly higher than that[(39.2±3.5)%,(45.8±3.4)%,(51.2±3.9)%and(56.7±4.8%)]at 22.5%,respectively(P<0.01).The inhibitory rate of platelet aggregation(47.9%,42.2%,36.5%and 32.6%)at 22.5%of brucea javanica oil was notably higher than that(23.4%,21.6%,17.0%and 14.6%)at 9.0%,respectively(P<0.001).There was a negative correlation between brucea javanica oil concentration and the aggregation ratio of platelet stimulated by the four agonists,respectively(r=-0.952,-0.961,-0.970,-0.975,P<0.001).At 9.0% of brucea javanica oil,the expression levels of FIB-R[(64.7±4.0)%]and CD_(62p) [(3.91±0.21)%] of platelet activated by ADP were significantly lower than that[(85.5±4.6)%and (5.05±0.27)%]at negative control,but remarkably higher than that[(36.2±3.9)%and(2.34±0.15)%]at 22.5%,respectively(P<0.01).There was a much higher inhibitory rate of platelet aggregation(57.7%)at 22.5%than that(24.3%)at 9.0%(P<0.01).The ratios(1.68±0.10 and 1.77±0.12)of F-actin photodensity at 22.5%and 9.0%to that in blank control were significantly lower than that(2.22±0.15)at negative control(P<0.01)but there was no statistical difference between the ratios in the group of 9.0%and 22.5%brucea javanica(P>0.05).Conclusions brucea javanica oil has special inhibitory effect on activated platelet and thrombosis in a dose-dependent manner.The mechanism is to inhibit the expression of fibrinogen receptor on external membrane of activated platelet,which is also related to the inhibition of F-actin and secretion of platelet.

Objective To explore the radiological features of intracerebroventricular central neurocytoma and so as to improve the diagnosis of this disease. Methods Thirty patients with pathologically confirmed intra-cerebroventricular central neurocytoma in Nanfang Hospital in past 7 years were analyzed retrospectively for their clinical,radiological and pathological features combined with literatures review. Results Lesions of central neuro-cytoma located at the Monro's foramen areas,the anterior horns and bodies of lateral ventricles.Twenty eight of the patients underwent MRI(with 4 patients received MRS)and 11 patients underwent CT.All cases revealed unilateral or bilateral hydrocephalus of the lateral ventricles and ventriculomegaly.Plain CT revealed heterogeneous isodensity or slighly high density lesions with multiple cystic degeneration,necrosis and calcification while a few lesions(4 le-sions)showed hemorrhage.Heterogeneous isointense or mild hypointense were demonstrated on T1-weight MRI and heterogeneous isointense or slightly hyperintense on T2-weight MRI.Multiple cystic degeneration(always showed as distinctive "soap bubble sign"), necrosis and calcification could also be found within the tumor. The solid compo-nent of tumor revealed slightly high to high signal intensity on DWI while the cystic and necrosis components showed low signal intensity.Most of the tumors showed mild to moderate enhancement with vessels passing through on contrast scan. All cases with 1H MRS showed with obviously increased in Cho peak and decreased in Cr and NAA peaks.In immunohistochemical assay,most of the tumors revealed positive expressions of Neu-N,Synaptophy-sin, GFAP and hypo-level Ki-67. Conclusions The intracerebroventricular central neurocytoma has some typical imaging manifestations.Comprehensive analysis of CT and MRI can be conducive to preoperative diagnosis and dif-ferential diagnosis with other tumors in the lateral ventricle.

Objective To explore the CT findings of gistric schwannoma and analyze the misdiagnosis causes to improve the diagnosis accuracy of the disease. Methods The findings of CT imaging in 15 cases with pathologically proved gistric schwannoma were reviewed restrospectively ,and relevant literatures were reviewed. Results In those 15 cases,3 were men,12 were women,the oldest was 61,the youngest was 33,and the medi-an age was 53.10 cases were located in the greater curvature side of gastric body ,2 cases in the gastric cardia ,3 cases in the diatal.14 cases underwent CT plain and contrast-enhanced scanning while 1 case only underwent CT plain. The 15 cases were single,round lumps with equable density. The performance of 14 routine enhancement scan was characterized by mild uniform strengthing of The arterial period ,further Strengthening of the venous phase,and mild prolonged delay. Conclusion The CT fingings of gistric schwannoma has certain characteristics. It usually occurred in gastric body with single type of circular lump and often presents with equable density. Homo-geneous progressive enhancement on dynamic CT is a characteristic finding of gistric schwannoma.

Aim To pick out the siRNA which could most effectively inhibit the expression of TLR4 in microglial cells and to detect the cytotoxicity of the transfection complex.Methods Five siRNAs were chemicaly synthesized:four of them were used to inhibit TLR4 expression in microglial cells,the rest was fluorescence-labeled mismatch siRNA as a nagative control.They were all transfected into microglial cells,respectively.TLR4 mRNA was detected 24 h after transfection by RT-PCR and its protein expression wasobserved by Western blot 48 h later.The cytotoxicity of complex was detected using MTT.Results ① The transfection rate was high enough in microglial cells with siRNA(40 pmol)and LipofectamineTM 2000(1 μl).② The TLR4 siRNA pool reduced TLR4 mRNA by 85%(siRNA_(439)),73%(siRNA_(312)),67%(siRNA_(1495))and 33%(siRNA_(2062))respectively compared with mismatch siRNA-treated group 24 h after transfection in a microglial cell line.③ The TLR4 siRNA439 was the most effective siRNA(P<0.01).④ The cell survival rates were above 85% in the groups of Lipofectamine~(TM) 2000 1 μl compound less than 40 nmol·L~(-1) siRNA.Conclusions ① The TLR4 siRNA_(439) can inhibit TLR4 expression most effectively in microglial.② 40 nmol·L~(-1) siRNA and 1 μl Lipofectamine~(TM) 2000 have low cytotoxicity,which are suitable for transfection.

Objective To evaluate the changes in expression of NF-κB, IL-6 and TNF-α in spinal cord in a rat model of bone cancer. Methods Seventy-two female SD rats weighing 150-180 g were randomly divided into 3 groups (n = 24 each): control group (group C);sham operation group (group S) and bone cancer pain group (group BP). Bone cancer was induced by intra-tibial inoculation of 1 × 105 Walker 256 breast cancer cells. Paw withdrawal threshold to mechanical stimulation was measured with yon Frey filaments. The expression of NF-κB p65, IL-6 and TNF-α mRNA in the spinal cord was determined by RT-PCR and the expression of NF-κB p65 by immuno-histochemistry and NF-κB p65 positive cell count was determined. Results The paw withdrawal threshold was significantly lower and the expression of NF-κB p65, NF-κB p65 mRNA, IL-6 mRNA, TNF-α mRNA and NF-κB p65 positive cell count in the spinal cord were significantly higher in group BP than in group C and S ( P ＜0.05 or 0.01 ). Conclusion Intra-tibial inoculation of Walker 256 breast cancer cells activates NF-κB in the spinal cord, leading to the increased release of IL-6 and TNF-α and mechanical hyperalgesia.

Objective To explore the CT findings of gistric schwannoma and analyze the misdiagnosis causes to improve the diagnosis accuracy of the disease. Methods The findings of CT imaging in 15 cases with pathologically proved gistric schwannoma were reviewed restrospectively ,and relevant literatures were reviewed. Results In those 15 cases,3 were men,12 were women,the oldest was 61,the youngest was 33,and the medi-an age was 53.10 cases were located in the greater curvature side of gastric body ,2 cases in the gastric cardia ,3 cases in the diatal.14 cases underwent CT plain and contrast-enhanced scanning while 1 case only underwent CT plain. The 15 cases were single,round lumps with equable density. The performance of 14 routine enhancement scan was characterized by mild uniform strengthing of The arterial period ,further Strengthening of the venous phase,and mild prolonged delay. Conclusion The CT fingings of gistric schwannoma has certain characteristics. It usually occurred in gastric body with single type of circular lump and often presents with equable density. Homo-geneous progressive enhancement on dynamic CT is a characteristic finding of gistric schwannoma.