Value of abdominal ultrasound scan, CT and MRI for diagnosing inferior vena cava tumour thrombus in renal cell carcinoma

Background We used abdominal ultrasound scan （USS）, computed tomography （CT） and magnetic resonance imaging （MRI） findings in venous spread of renal cell carcinoma （RCC） to determine the superior extent of inferior vena cava （IVC） thrombus and IVC wall invasion and compared them with surgical and pathological reports. Methods From January 1999 to August 2007, 25 patients were diagnosed with RCC with IVC tumour thrombus. Before their operation, all patients had USS, contrast enhanced CT and MRI to find the superior extent of tumour thrombus and IVC wall invasion. All postprocessing techniques were performed by experienced radiologists. Two pathologists reported on all pathology specimens. The superior extent of tumour thrombus was confirmed by the senior surgeon at each operation, using the levels of thrombus defined according to 2004 Mayo Clinic classification. The radiographic results were compared with surgical and pathological findings. Results All patients had radical nephrectomy and tumour thrombus excision. Eight patients had RCC on the left side and 17 on the right side. According to the clinical and pathological findings, 6 patients had level I tumour thrombus, 9 level II, 5 level III and 5 level IV. Six patients had IVC wall invasion. No patient had evidence of lymph node or distant metastases. Of the 25 patients, USS correctly diagnosed the superior extent of tumour thrombus in 18/25, CT 23/25 and MRI 23/25. USS found 1 case of IVC wall invasion preoperatively. Conclusions Multidectector computed tomography and magnetic resonance imaging are comparable and more effective than abdominal ultrasound in diagnosing inferior vena cava tumour thrombus in renal cell carcinoma. None of the three methods can detect inferior vena cava wall invasion.     

Recalling the glorious past six decades and foreseeing a promising new century — the 60-year development of Chinese urological surgery

Urological surgery did not take shape as a discipline until the establishment of the new China. From small and weak to large and strong, and with the painstaking efforts of several generations since the inception of reform and opening-up policy, China＇s urological surgery has developed into a significant subject subordinated to clinical medicine.     

Imaging features of central nervous system haemangiopericytomas

Intracranial and spinal haemangiopericytomas are uncommon, durally based tumours. They macroscopically resemble meningiomas but are distinct histologically, have a more aggressive natural history and require different management. We present a pictorial review illustrating the radiological manifestations of these tumours that will aid in their preoperative identification.     

Modified anterior compartment resection of the thigh

For large soft tissue sarcomas of the anterior thigh, an anterior compartment resection is often performed. This may leave the patient with the inability to extend the knee. In our practice, we find that it is usually possible to preserve one of the heads of the quadriceps, usually the vastus medialis, with intact innervation, and thus preserve significant extension function of the knee joint, while the requirements for a radical oncologic procedure are being met. The modified anterior compartment resection preserves one or more heads of the quadriceps and requires a thorough knowledge of the course and distribution of the branches of the femoral nerve from the level of the inguinal ligament to their termination at the individual heads of the quadriceps femoris.     

Epstein Barr virus latent membrane protein-1 in Hodgkin's lymphoma in Nigerians

Background

The burden of lymphomas on the health care system in Nigeria is enormous. Correct diagnosis and identification of aetiological factor are important steps in reducing this burden.

Methods

Eight cases diagnosed as HL within a period of six years at the Obafemi Awolowo University teaching Hospital, Ile-Ife, Nigeria by haematoxylin and eosin (Hand E) only were immunophenotyped using the indirect immunoperoxidase method. Epstein-Barr virus latent membrane protein-1 (LMP-1), CD15 and CD30 immunohistochemistry was also performed. The clinical characteristics of each patient were documented.

Objectives

To document the frequency of involvement of Epstein-Barr virus in cases of HL seen in a university hospital in Nigeria.

Results

Out of the eight cases diagnosed by H&E as HL immunophenotyping showed only five were HL. The rest were non-Hodgkin''s lymphoma (2 diffuse large B-cell and 1 null cell ALCL). All were cases of classical HL with 60% being of the mixed cellularity (MC) subtype. There were 2 males and 3 females with ages ranging from 7 years to 40 years. All presented with cervical lymphadenopathy and three had splenomegaly in addition. 60% of the tumour was EBV positive, all of the MC subtype. Three patients had chemotherapy. Eventually all were lost to follow-up. There was no case of the nodular lymphocyte predominance variant.

Conclusion

Mixed cellularity is the most common subtype and is the only subtype associated with EBV positivity in this study. Epstein-Barr virus probably plays an important role in the aetiology of HL in Nigerians.Running title: Epstein-Barr virus, Hodgkin''s lymphoma in Nigerians     

胰岛素抵抗和非胰岛素抵抗多囊卵巢综合征患者的对比研究

目的探讨多囊卵巢综合征(PCOS)胰岛素抵抗(IR)患者的临床特征。方法选取48例PCOS患者,将稳态模型胰岛素抵抗指数(HOMA-IR)>3.8或葡萄糖及胰岛素曲线下面积比值(AUC葡萄糖/AUC胰岛素)<1.0的PCOS患者作为IR组(30例),上述两个标准均不符合的PCOS患者作为非IR组(18例)。比较IR组和非IR组患者的体质指数(BMI)、血脂水平及各项性激素水平。结果 (1)IR组患者BMI及肥胖者所占比例均显著高于非IR组,差异有统计学意义(P<0.05);(2)IR组患者三酰甘油、载脂蛋白B水平均显著高于非IR组,而高密度脂蛋白、载脂蛋白AⅠ水平则显著低于非IR组,差异均有统计学意义(P<0.05);(3)IR组患者黄体生成素水平显著低于非IR组,睾酮水平则显著高于非IR组,差异亦有统计学意义(P<0.05)。结论 (1)存在IR的PCOS患者更容易出现血脂异常;(2)PCOS患者性激素有不同改变,存在IR者以睾酮升高为主而非IR患者则以黄体生成素升高为主。     

中药复方逆转胃癌前病变的临床研究

目的探讨中药复方对胃癌前期病变(PLGC)的逆转作用。方法将200例符合慢性萎缩性胃炎(CAG)伴肠上皮化生(Im)和(或)异型增生(Dys)诊断标准的病人随机分为中药治疗组(100例)和胃复春对照组(100例),3个月为一个疗程,治疗2个疗程后对临床症状、胃镜及病理结果、幽门螺旋杆菌(Hp)检验结果进行比较。结果治疗后治疗组临床疗效、胃镜及病理(CAG、Im、Dys)结果、Hp检验结果与对照组比较,差异有显著性(χ2=5.308~9.072,P<0.05)。结论中药复方是逆转PLGC的有效方剂。     

青蒿素对变应性接触性皮炎小鼠Treg/Th17免疫平衡的影响

目的探讨青蒿素(Art)在变应性接触性皮炎(ACD)中对Th17和Treg的影响及机制。方法以DNFB致敏和激发制作小鼠ACD模型,局部外涂Art进行干预,采用RT-PCR和ELISA检测Treg/Th17细胞特异性核因子及相关细胞因子的表达与含量,流式细胞术检测Treg细胞数量,West-ern blot方法检测信号转导子和转录激活子STAT3的磷酸化活性表达。结果与正常组相比,模型组IL-6、IL-17含量、ROR-γt及STAT3的活性表达明显升高,同时Foxp3表达降低。Art明显降低ROR-γt表达、下调IL-6及IL-17水平,同时增加Foxp3表达并促进Treg产生,减弱STAT3的磷酸化活性。结论 Art可能通过调节Treg/Th17免疫平衡,对DN-FB诱导的ACD小鼠发挥免疫治疗作用。     

超声评价代谢综合征患者下肢动脉硬化

目的应用高频超声研究代谢综合征患者下肢动脉硬化的特点。方法代谢综合征（Metabolic Syndorme,MS）患者49例行双下肢动脉超声检查,测量动脉内-中膜厚度,斑块检出率、动脉管腔狭窄率。结果49例患者双下肢动脉中内-中膜均有不同程度增厚（0.9～2.5mm）,45例（92%）患者双下肢动脉出现弥漫性斑块,其中6例（12%）患者胫前动脉、足背动脉狭窄,狭窄率52%～79%,3例（0.06%）患者双下肢动脉弥漫性狭窄,双侧胫前、足背动脉重度狭窄,狭窄率72%～99%。结论双下肢动脉硬化、狭窄是代谢综合征患者严重血管并发症,高频超声检查可为临床提供可靠诊断依据。