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Opportunistic infections often occur in immunocompetent hosts. Human immunodeficiency virus (HIV) infection and underlying diseases that can cause immunodeficiency or immune disorders are the main susceptibility factors. In recent years, it has been found that there are some new potential immunodeficiency mechanisms such as anti-cytokine antibody diseases and primary immunodeficiency diseases that are closely related to various opportunistic infections such as Talaromyces marneffei, non- Tuberculous mycobacteria and Aspergillus infections in non-HIV hosts. Moreover, many problems including clinical infection phenotype, immunodeficiency regulation mechanisms and treatment strategies have drawn increasing attention. This review summarized the potential mechanisms of immunodeficiency and opportunistic infections in non-HIV hosts.
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Objective To explore the potential risk of misdiagnosis of pharyngeal esophageal diverticulum( PED) for the treatment of thyroid nodules with thermal ablation and its rapid and effective method of diagnosis . Methods The process of diagnosis and treatment were reviewed on 5 cases of PEDs which had been misdiagnosed as thyroid nodules and recommended for thermal ablation therapy . A comprehensive analysis was carried out for the reasons of misdiagnosis ,the timing and clues of the diagnosis as well as the advantage of swallow contrast-enhanced ultrasonography ( sCEUS ) in achieving rapid and correct diagnosis . Results The lack of recognition and vigilance to the acoustic image of PED were the direct causes of misdiagnosis . Five cases of PED misdiagnosed as thyroid nodules were all discovered by the same chief operator before thermal ablation . They were confirmed through sCEUS and mistreatment by ablation were fortunately avoided ,but all true thyroid nodules requiring treatment were safely ablated . Conclusions PED is easily misdiagnosed as thyroid nodule .Improving the recognition and vigilance of the ultrasonic features of PED ,strictly implementing the reconfirming ultrasound examination by the chief operator ,and promptly conducting sCEUS are sensible measures to quickly correct the diagnosis and prevent w rong ablation of PED .
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Objective To explore the feasibility of quantitative evaluation in fibrosis by geometrical characteristics of hepatic capsule based on computer technology . Methods Fifty-nine rabbits models of fibrosis were established and then were divided into four groups according to the results of pathologic examination:S0-S1 ,S2 ,S3 and S4 groups . Two-dimensional high-frequency ultrasound images of hepatic capsule of the rabbits were collected at 6th week ,12th week and 18th week . All the images were collected to obtain the contour line of the capsule and its shape control points by combining manual monitoring and gradient optimization methods . Subsequently ,the mean value and variance of angles between adjacent seed points and the number of continuous segments of the contour line ,were extracted to evaluate the smoothness and continuity of the contour line of the hepatic capsule . Results With aggravating fibrosis ,the mean value and variance of the angles were gradually increased ,and the differences between S0-S1 and other 3 groups were all statistically significant( P <0 .05) . Similarly ,the number of segments required to make the sum of lengths of continuous segments reach up to 80％ of the total width of the imaging section was gradually increased . The differences between S0-S1 and S4 group( P =0 .025) ,S2 and S4 group( P =0 .004) were also statistically significant . Conclusions Analysis of geometrical characteristics of the hepatic capsule partially indicates the presence of early-stage fibrosis ,and is expected to provide a quantitative method for non-invasive assessment of fibrosis .
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OBJECTIVE:To observe therapeutic efficacy and safety of tegafur,gimeracil and oteracil potassium combined with oxaliplatin assisting with radiofrequency ablation(RFA)in the treatment of liver metastases after radical operation of rectal cancer. METHODS:A total of 130 patients with liver metastases after radical operation of rectal cancer were randomly divided into control group and observation group,with 65 cases in each group. After RFA one week,control group was given Oxaliplatin injection 130 mg/m2 intravenously,d1,more than 3 h. Observation group was additionally given Tegafur capsule,for consecutive 14 d,drug with-drawal of 7 d,as a treatment course. A treatment course lasted for 3 weeks,and both groups received 2 courses of treatment. Short-term efficacies of 2 groups were observed as well as complete ablation rate,local recurrence rate,survival rate and the occur-rence of toxic reaction. RESULTS:The total remission rate,disease control rate,complete ablation rate,1-year,2-year and 3-year survival rates of observation group were significantly higher than those of control group,and local recurrence rate was significantly lower than control group,with statistical significance(P0.05). CONCLUSIONS:Tegafur,gimeracil and oteracil potas siucn combined with oxaliplatin assisting with RFA shows significant therapeutic efficacy for liver metastase after radical operation of rectal cancer,and can significantly de-lay disease progression,reduce local recurrence rate and prolong survival time,and does not increase the occurrence of toxic reac-tion.
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Objective To summarize the multimodal ultrasonographic characteristics primary thyroid lymphoma (PTLs), and to discuss the diagnosis and differential diagnosis of PTLs. Methods Multimodal ultrasonographic charactericsits of six cases of PTLs were analyzed retrospectively. All of the patients were examined by the conventional two-dimensional ultrasound (2DUS), color Doppler flow imaging (CDFI), contrast-enhanced ultrasound (CEUS), three-dimensional ultrasound (3DUS) reconstruction and elastography imaging (EI) from October 2011 to February 2016 in Changzheng Hospital, affiliated to Secondary Military Medical University. All diagnoses were confirmed by ultrasound-guided percutaneous biopsy.Results (1) 2DUS: six cases of PTLs without capsule were observed as diffusely enlargement type (two cases), unilateral nodular type (one case, on left lobe),and bilateral multiple nodular type (the other three cases). The margin of the multiple nodules were not clear, and some nodules were fused with each other.There were four cases of heterogeneous (extremely) hypoechogenicity and two cases of mixed echogenicity, All of the lesions were characterized by various striped and reticular hyperechogenicity interiorly on ultrasonograms, and only one case showed slightly posterior enhancement. Except one case, multiple cervical lymphnodes hyperplasia were identified on neck regionⅡ-Ⅴin five cases. (2) CDFI and CEUS:CDFI showed abundant blood flow signals in the PTLs nodules peripherally and internally. The striped blood flow was observed in the lesions, and spectrum showed as artery and veins. The plentiful vascular tree was also found in the enlarged lymphnodes. By using high frequency CEUS, six cases of the PTLs demonstrated diffuse and heterogeneous enhancement significantly, including little necrosis area without prominent contrast agent filling in two cases. (3) 3DUS reconstruction: Various striped and reticular hyperechoic features were found on the surface of six cases of PTL nodules. (4) EI: All lesions were soft in six cases. The ratio of elastic strain rate was 1.28-1.96, average (1.82±0.29).Conclusion The ultrasonographic features of PTLs are of certain characteristics, and multiple modes of ultrasound examination can help to grasp the comprehensive imaging informations of PTLs, which should be encouraged positively to facilitate the early detection, early diagnosis and early treatment for PTLs.
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BACKGROUND:A number of studies have shown that there are many inducible methods by which bone marrow mesenchymal stem cel s can differentiate into hepatocytes, but the specific molecular mechanism is unclear yet. OBJECTIVE:To review the programs and underlying mechanisms by which bone marrow mesenchymal stem cel s differentiate into hepatocytes. METHODS:A computer-based online search of CNKI, VIP, WanFang and PubMed databases was performed to retrieve articles about directional differentiation of bone marrow mesenchymal stem cel s into hepatocytes published between 2004 and 2015. The key words were“hepatocyte (-like) cel s, bone marrow mesenchymal stem cel s, differentiation”in Chinese and English, respectively. Final y, 62 articles were included in result analysis. RESULTS AND CONCLUSION:There are many programs for hepatic differentiation of bone marrow mesenchymal stem cel s, but the specific molecular mechanism is stil unclear. Many studies mainly focus on Notch signaling pathway, Wnt/β-catenin signaling pathway, P38 signal pathway, miR-122 and effect of calcium ions. Bone marrow mesenchymal stem cel s that can be induced to differentiate into mature hepatocytes provide an ideal cel ular source for hepatocyte transplantation and artificial liver, which is proposed to be a new strategy for clinical treatment of end-stage liver disease.
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Objective To explore the short and long term curative effects of percutaneous transhepatic cholangioscopic lithotomy (PTCSL) in the treatment of intrahepatic stone (IHS).Methods 38 IHS patients were enrolled,who were treated with PTCSL between January 2008 and July 2013.Results PTCSL was successfully completed in all the 38 IHS cases.Stone clearance rate was 84.2％ and the average episode of stone removal was (2.6 ± 0.9) times.Average diameter of percutaneous transhepatic fistula was (18.4 ± 0.6) F and the average time from percutaneous transhepatic puncture and fistulization to cholangioscopic lithotomy was (7.2 ± 0.7)d.The average operation time was (68 ± 20) min,intraoperative blood loss was (20 ± 13) ml,and hospitalization was (4 ± 2) days.The hepatolith recurrence rate in patients with stones completely removed was 37.5％ (12/32),and 1 case developed into biliary cirrhosis.Patients with calculi residual suffered from higher hepatolith recurrence rate of 83.8％ (5/6),with biliary cirrhosis found in 1 case.Conclusions PTCSL is safe and effective in treating primary IHS,which is indicated in multiple recurrent IHS especially in after biliary surgery patients.It has the advantages of minimally invasion,less bleeding,less postoperative pain,less complications,and fast postoperative recovery.
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Objective To evaluate the preoperative value of dual contrast-enhanced ultrasound (DCEUS) on obstructive jaundice.Methods Seventy-nine patients with obstructive jaundice were included.DCEUS (percutaneous transhepatic contrast-enhanced cholangio-ultrasonography combined with intravenous contrast-enhanced ultrasound) was performed preoperatively.The biliary obstruction plane,degree and cause were observed.After surgery,the diagnostic accuracy of DCEUS was compared with final pathologic results respectively.Results The overall accuracy of DCEUS in determining the flat,degree and cause of biliary obstruction was 98.7％,98.7％ and 93.7％,respectively.The DCEUS and golden standard were both almost perfect for assessing biliary obstruction with Kappa values of 0.979,0.837 and 0.975(P =0.000).The overall diagnostic accuracy of obstruction combined with obstruction plane,the extent and cause was 92.4％.Conclusions DCEUS could be considered a feasible,reliable,and exhaustive method for preoperative evaluation of obstructive jaundice.
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Objective CD8 +T cells increased in the airway of patients with chronic obstructive pulmonary disease and exis -ted constantly .The aim was to investigate the role of CD 8 +T-cells in rats with chronic bronchitis ( CB) which was induced by cigarette smoking and intratracheal injection with lipopolysaccharide ( LPS) . Methods 18 health Wistar rats were radomly divided into sham smoking group(group A), CB group(group B) and N-acetylcysteine prevention group (group C).The rats in group B and group C re-ceived intratracheal injection with LPS twice and exposed to cigarette smoking for 4 weeks to induce CB model .The rats in Group C re-ceiving intragastric administration with N-acetylcysteine (NAC)(200mg/kg) before received LPS and smoking.Group A was the sham smoking group.The lung tissue of all rats were stained by HE then evaluated about pathological scores .The expression of nuclear fac-tor-κB (NF-κB), major histocompatibility complex class I (MHCI), CD8 +T cell and Vascular endothelial growth factor (VEGF) in airway were detected by immunohistochemisty which was stained by labeled streptavidin biotin method . Results The pathological scores of airway ( 10 .83 ±3 .31 ) in group B were higher than (1.17 ±2.40) in group A(P <0.05).The pathological scores of airway(4.66 ±2.25) in group C were less than (10.83 ±3.31) in group B(P <0.05).The expression of NF-κB(4.84), MHC I (2.48),CD8 +T cell(5.35)and VEGF(5.02) in airway increased in group B when compared with (1.18, 1.25, 1.33) and (1.18) in group A respectively(P <0.05).The expression of NF-κB (2.18), MHC I(1.46),CD8 +(2.35)and VEGF(2.02) in airway decreased in group C when compared with (4.84), MHC I(2.48),CD8 +T cell(5.35)and VEGF(5.02) in group B respectively (P<0.05 ). There were positive correlations between the expression of NF-κB, MHC I and CD8 +T cells in airways(r=0.670, r=0.701, respec-tively, all P<0.01).There were positive correlations between the expression of CD 8 +T cells and VEGF the pathological scores of air-ways(r=0.689, r=0.782, respectively, all P<0.01). Conclusion NAC can inhibit airway inflammation which is regulated by CD8 +T-cells and VEGF through suppressing the expression of NF -κB and MHC I.
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Objective To investigate the ultrasonic and pathological features of porcine striped muscle injury from thermal and chemical factors respectively, and to analyze the limitation of ultrasound diagnosis given by doctors with different skill levels. Methods An experimental study using fresh porcine striped muscle in vitro was designed, where the injury were caused by microwave ablation (2 450 MHz) and Anhydrous acetic acid (99.8%) injection separately. Blind to pathologic results, the two-dimensiona sonograms taken from each model were analyzed by sonographers with different skill levels independently. Finally, the diagnoses were evaluated and compared among them. Results Two-dimensional sonograms showed distinct changes of the textures in both injury models, which was characterized as the disappearance of regular tissue structure. However, the corresponding histopathology revealed obvious differences between the two interventions on ultrasonograms. There was no statistical difference between chief physician and attending doctor (both of them had over 5-year experiences on skeletal muscle ultrasound ) in identifying the ultrasonic features of boundary, shape and muscle texture (Kappa=0.933, 0.845, 0.789;Kappa=0.790, 0.935, 0.865, all P<0.05). Compared with residents′diagnosis, there were signiifcant differences in identifying the ultrasonic features of echo level and muscle texture in both injury models:Echo level in thermal injury group:chief physician vs residents, Kappa=0.323;attending doctor vs residents, Kappa=0.297. Texture feature in thermal injury group:chief physician vs residents, Kappa=0.259;attending doctor vs residents, Kappa=0.112. Texture feature in chemical injury group:chief physician vsresidents, Kappa=0.253;attending doctor vs residents, Kappa=0.070. Conclusions Microwave ablation and Anhydrous acetic acid can cause different histopathologic changes in correspondence with various features on two-dimensional sonograms. But ultrasonographers with different skill levels leads to signiifcant variations in identiifcation and qualitative diagnosis, which is impossible to be quantitatively analyzed. Chief physician and attending doctor can draw a consistent conclusion and demonstrate the ultrasounic characteristics in porcine striped muscle injury model from thermal or chemical factors.
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Objective To make a comparative assessment on both the therapeutic effects and side effects between percutaenous lauromacrogol injection therapy(PLIT) and percutaenous ethanol injection therapy(PEIT) for simple hepatic or renal cyst.Methods In group A,55 patients with simple hepatic or renal cysts underwent ultrasound-guided aspiration and successive PLIT.The intra-operative side effects were investigated and the therapeutic effects assessment by using ultrasonography was conducted 3 months after the treatment.In group B,60 patients with simple hepatic or renal cysts had received ultrasound-guided aspiration and PEIT sometime before.The intra-operative side effects and therapeutic effects on the thirdmonth ultrasonography were independently reviewed according to their case records.Results In group A,3 patients(5.5 ％) expressed slight discomfort but not pain while receiving lauromacrogol injection.Follow-up ultrasound examination at the end of third month demonstrated the cysts in 43 patients completely regressed,while cysts in rest 12 patients shrank over 50 ％ in size,showing the overall response rate(ORR) and completely cure rate(CCR) were 100％ (55/55) and 78.2％ (43/55) for PLIT respectively.In group B,12 patients(20％) suffered from slight to moderate irritating pain or drunk performance.The third-month ultrasound examination disclosed that cysts in 47 patients completely vanished,and cysts in the other 13patients shrank more than a half,indicating the ORR and CCR were 100％ (60/60) and 78.3 ％ (47/60) for PEIT respectively.Conclusions Although their therapeutic efficacy are perfectly similar,PLIT is much more superior to PEIT in term of less and minor side effects.
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Objective To explore the characteristics of changes in temperature and stiffness within the microwave-induced ablation region.Methods A type of Thy-ablation microwave antenna was used upon a design of various combination of ablation duration and power to induce heated region in samples of fresh porcine liver.Three special sites were set to assess the corresponding temperature and stiffness in each heated region.The temperature was continuously measured by using electronic thermometer with microwave on going,while stiffness was determined 5min after the ending of ablation by using real-time ultrasonic elastography,strain ratio,a quantitative indicator.Results The SR values and temperature determinations decreased progressively from the central to the peripheral area of the heated region.There was a linear regression between the temperatures (X) and SRs (Y),with Y =0.666 X-37.17.A significant correlation exists between X and Y,with the correlation coefficient being 0.956(P ＜0.001).The stiffness and temperature at the central sites are variable with the changes of both ablation time and power,but little changed at the peripheral sites of heated-region,which we name a phenomenon due to the ending effect of microwave propagation.Conclusions Temperature and stiffness increase considerably following microwave radiation but they are heterogeneously distributed within the ablated region in porcine liver.The characteristic gradient changes are confirmed of both temperature and the elasticity.It is presumable that good recognition and understanding and full utilization of these characteristics are conducive to reasonable control of tumor microwave ablation therapy.
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Objective To investigate the elasticity reduction of liver tissue due to microwave ablation and the relevance to the histographic damages. Methods An experimental study using fresh porcine liver was designed. Elasto-ultrasonography scanning both in color display and strain ratio calculations was conducted before and 5 min after microwave ablation ( 2450 MHz) in manner of antenna insertion under ultrasound guidance to determine the alterations of the liver elasticity, in correspondence with the histopathologic assessment of each ROI. Results Elasto-ultrasonography showed a significant elasticity reduction and hardness augment of the targeted liver tissue and the corresponding histopathology revealed increases in the amount of massive coagulative necrosis and coking of liver cells after microwave irradiation,in proportional to the applied field power and working time. Conclusions Elasto-ultrasonography helps to demonstrate microwave-induced lesion in porcine liver got rapidly hardened. It is possible to estimate the tissue necrosis to the changing of tissue hardening.
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Objective To represent the high-resolution ultrasonic profiles of diffuse sclerosing variant of papillary thyroid carcinoma (DSVPTC) and highlight the importance of ultrasound examination for detecting this rare entity. Methods The document of clinical presentations and thyroid ultrasound imaging information leading to correct diagnosis were reviewed in association with the microscopic findings of excised thyroid specimen. Results The average age of the eight patients was (18.88 ± 3.59) years(range from 12 to 24) with a gender ratio of 2 males to 6 females. Their predominant clinical presentations were enlargement (8/8) and hardening(6/8) of the involved thyroid lobes. The ultrasound imaging features were increase in the width and thickness of involved thyroids, hypoechoic and heterogeneous internal echoes, containing multiple,diffuse,and fine hyperechoic spots but without formation of any masses, and multiple enlarged lymph nodes in the bilateral jugular chains due to cancer cell metastasis. Ultrasound diagnosis of the first case was malignant thyroid tumor, but the following consecutive 7 patients were all definitely interpreted as DSVPTC. Conclusions The clinical presentations alone is less valuable in diagnosis of DSVPTC, but the characteristic features on high-resolution ultrasonography are highly sensitive and indicative.
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Objective To establish a treatment proposal of thyroid adenoma by using percutaneous radiofrequency ablation(RFA) and investigate its techniques and skills, means and steps, and safety and efficacy. Methods Contrast-enhanced ultrasound-guided percutaneous RFA of thyroid adenomas were conducted on 202 patients by using an auto-controlled bi-polar electrode system. The indications of thyroid RFA,the optimal puncture route,the ways of anesthesia administration, protection of vital neck vessels and recurrent laryngeal nerve(RLN) and reduction of bleeding from core biopsy, indicators of ending ablation procedure following a complete ablation were investigated and analyzed. Resalts An adenoma smaller than 20 mm in maximal diameter was the optimal candidate for RFA. Either of two puncture routes could be selected upon the target lesion's location. Areas surrounding to the thyroid capsule needed adequate local anesthesia to kill pain. Liquid-isolating maneuver could effectively protect carotid artery and RLN from core needle cutting and electrode heating injury. Advanced block of supplying arteries with heating markedly reduced bleeding involved in the biopsy. Multipoint and multicenter ablation was essential to a complete coagulation. Filling-defect in the ablated adenoma on CEUS was the key sign to terminate ablation procedure. Conclusions Percutaneous bi-polar RFA was proved feasible, effective, safe and supermicroinvasive for treating thyroid adenoma under the way stated here of puncture and technical points and use of CEUS for monitoring.
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Objective To detect fat emboli in cardiac chamber of the patients undergoing total knee arthroplasty(TKA) by transesophageal echocardiography(TEE), and to discuss the relevant clinical value.Methods Eleven female patients with 12 osteoarthritis(OA) knees were underwent TKA. According to whether using tourniquet or not,12 knees were divided into 2 groups at random:tourniquet-related group (6 knees) and control group(6 knees). Echo intensity and ultrasonic characteristics of fat emboli in cardiac chamber were studied dynamically by multiplane TEE in various periods of the whole operation. Results All of the patients were implanted knee prostheses successfully. In different periods of TKA, fat emboli appeared as isoechoic or hyperechoic particles, which were found in right atrium, but nothing could be found in left heart. The imaging of the particles was flowing with duration time of 10～600s, like dots, lines, "moving star" or "shower". While femur expanding(0～3mins),the particles in right atrium and ventricle became more and more, and the echo intensity became significantly higher than those in other periods. After releasing tourniquet(0～5mins),most particles with highest echo intensity were observed in right heart,showing like "snowstorm" in tourniquet-related group, and more emboli were still detected at the end of monitoring (10 min after releasing tourniquet) by TEE,compared to the control group. No patient suffered from fat embolism syndrome(FES) with clinical manifestation. Conclusions Fat emboli in cardiac chamber can be observed sensitively by real-time TEE dynamically during TKA. It should be encouraged and promoted to analyze ultrasonic characteristics to facilitate the early detection, early diagnosis and early clinical intervention for the subclinical type of FES.
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Objective To investigate the technical feasibility and clinical significance of non-vascular contrast-enhanced ultrasound(NVCEUS) in screening pyelogenie cyst out of simple renal cysts so as to avoid damage to the urinary tract from absolute ethanol while undergoing percutaneous aspiration and ethanol sclerotherapy(PAEST). Methods Following an inclusion criteria 23 patients with renal cysts were selected to receive NVCEUS scanning by means of administrating SonoVue contrast agents through puncture needle into their renal cyst lumen prior to the injection of absolute ethanol for sclerosing treatment. By the demonstration of hyperechoic contrast agents leaving from intra cyst into renal collecting system,a pyelogenic cyst was defined. The patients with this kind of cyst was not allowed for further ethanol sclerotherapy. Results NVCEUS made 3 patients with pyelogenic cyst resembling simple ones free from ethanol selerotherapy,and 4 patients suspicious of pyelogenic cyst due to weird cyst configuration remain in the list of simple cyst for further selerotherapy. Conclusions NVCEUS of renal cyst is highly capable of differentiating pyelogenie cyst from simple cyst and highly valuable in increasing the safety for the procedure of PAEST.
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Objective To study the pathological characteristics of interleukin-16 (IL-16) and CXC chemokine receptor 3 (CXCR3) in pulmonary artery of smokers with normal lung function and smokers with chronic obstructive pulmonary disease (COPD). Methods We examined surgical specimens from three groups of subjects undergoing lung resection for localized pulmonary lesions: group NS(nonsmokers with normal lung function, n=10); group S (smokers with normal lung function, n=13); group COPD (smokers with stable COPD, n=10). The clinical datas including blood gas analysis, pulmonary function,BMI, smoking index, BODE index, six-minute-walk distance (6MWD), Medical Research Council dyspened scale (MRC), St. George Respiratory Questionnaire (SGRQ) were recorded in all subjects before the operation. We applied technique of hematoxylin-eosin staining to observe pathomorphological changes of the pulmonary arteries. The concentration of IL-16 in lung tissues were measured by ELISA. Muscularized arteries were examined with immunohistochemical methods to identify T-lymphocytes (CD_3), CD_4 T-lymphocytes, CD_8 T-lymphocytes, IL-16, CXCR3. The correlation of IL-16 and CXCR3 in muscnlarized arteries in smokers with stable COPD were analysed. Results (1) The group COPD showed the highest concentration of IL-16 in lung tissue (P <0. 01) . The concentration of IL-16 in group S was higher than group NS (P<0.05). (2) Both in group S and group COPD, the percentage of the muscularized arteries that contained CXCR3 and IL-16 were increased as compared with group NS (P < 0. 01). Moreover there were statistical significance have been observed between group COPD and group S(P < 0.01). (3) The intensity of IL-16 infiltrating the muscularized arteries in group COPD showed a positive correlation with CD_3~+ T-lymphocytes, CD_8~+ T-lymphocytes, CXCR3 (r=0.639,0. 803,0. 696; P < 0. 05 or P < 0. 01), smoking index, BODE index (r= 0.737,0. 704; P < 0. 05). There was inverse relationship between the content of IL-16 in the muscularized arteries in group COPD and forced expiratory volume in one second% predicted (FEV_1 % Pred) and 6MWD (r=-0.803,-0.787; P<0.01). We also found the intensity of CXCR3 infiltrating the muscularized arteries in group COPD showed a positive correlation with CD_3~+ T-lymphocytes,CD_8~+ T-lymphocytes(r=0.650,0.767; P<0.05), smoking index, BODE index (r=0.650,0.767; P< 0.05). There was inverse relationship between the content of CXCR3 in the muscularized arteries in group COPD and FEV_1 % Pred and 6MWD (r=-0.778,-0.774;P<0.01). Conclusions (1) Both in group S and group COPD, IL-16 and CXCR3 were mainly expressed in lymphocytes which were correlated with CD_8~+ T-lymphocytes infiltrating the muscularized arteries. There were some suggestion that IL-16 prohaly recruited CD_8~+ T-lymphocytes into muscularized arteries by enhancing the expression of CXCR3. (2) The intensity of IL-16 and CXCR3 were correlated with the index of clinical and pulmonary function that suggested pulmonary arterial inflammation might be one of the key factors associated with the progression of COPD, and inhibiting the pulmonary artery inflammation played an important role in prevention and cure of COPD.
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Objective To summarize the sonographic characteristics of parathyroid adenomas(PAs) and investigate the diagnostic values and best diagnostic thinking for an early detection. Methods Sixteen cases finally proved with PAs were retrospectively analyzed of their clinical complaints, the department for their initial consultation,indicative ultrasound findings for neck scanning, major manifestations of PAs on a series of three-mode ultrasound imagings,association of adenoma sizes to serum parathyroid hormone(PTH) levels. Results On multimode ultrasound images, the PAs were multidisciplinary morphologic, homogenously hypoeehoic,absent of calculus and necrosis,highly vascularized with color signals,and similar to thyroid in contrast agents perfusion. Serum PTH levels were elevated in accordance with increase of adenomas' size. Among the 16 cases 12 were defined as with parathyroid incidentalomas, to which liver or/ and kidney stones were contributed as indicatives. Conclusions High frequency ultrasound with multiple imaging modes are most suitable for scanning and detection of neck PAs. For those with stones in liver and urinary tracts, unknown bone fracture etc, ultrasound scanning of the neck parathyroids used to reveal latent PAs.
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Objective To establish the method and assess the safety，feasibility and clinical efficacies of percutaneous transhepaticcontrast-enhancedcholangio-ultrasonography(PTCECUS).Methods Twenty-one patients aged(58.5±16.65)years(range 27-93)with biliary obstruction or stricture underwent percutaneous transhepatic cholangiodrainage or ch01ecystodrainage.A dose of more than 50 ml of 0.94% Sono Vue(Bracco，Itay)solution was injected into their bile ducts(n=17)and cholecysts(n=4)through the drainage catheter.Their biliary tracts，cholecysts and duodenums were scanned under contrast pulsed sequencing mode(CPS，Sequoia 512，Siemens)to achieve related contrast-enhanced ultrasonograms.Severity of biliary obstruction were assessed according to the PTCECUS findingswith a comparison toconventionalultrasonography(CVUS)，magnetic resonance cholangiopancreatography(MRCP)and percutaneous transhepatic cholangiography(PTC)in a part of the patients.Results①PTCECUS gave rise to good-quality contrast-enhanced uhrasonograms of biliary tracts.②PTCECUS was superior to CVUS and in consistence with MRCP and PTC in evaluating the severity of biliary tract obstruction.This method helped to make a proper design for biliary drainage.③PTCECUS was more efficient than PTC in that PTC had the patients receive transhepatic puncture and cholangiography in separated departments.④Neither any complications immediate from transhepatic puncture and administration of SonoVue inall the 21 patients，nor those 1 to 8 months late during ultrasound follow up in 14 patients were found.Conclusions PTCECUS，characterized in bettering the display of biliary tracts，especially the severity of obstruction of biliary tracts，is safe through the procedure and valuable in supervising biliary drainage against obstructive jaundice.