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Objective@#To investigate the diagnostic value of ultrasonography.in elderly patients with gastric tumors.@*Methods@#A total of 42 elderly patients with gastric tumors confirmed by surgery pathology underwent oral contrast-enhanced ultrasonography and electronic gastroscopy.The diagnostic effect of oral contrast-enhanced ultrasonography and electronic gastroscopy were compared based on the gold standard of surgical pathology.@*Results@#Of the 42 elderly patients with gastric tumors, 40 patients were diagnosed by oral contrast-enhanced ultrasonography and the surgical pathology(40/42, 95.2%), with Kappa value of 0.812.And 38 cases were diagnosed by electronic gastroscopy and the surgical pathology(38/42, 90.5%), with Kappa value of 0.718(P<0.05). Based on gold standard of surgical pathology results, the accuracies of T1, T2, T3 and T4 stage by oral contrast-enhanced ultrasonography were 95.0%(38/40), 95.0%(38/40), 100.0%(40/40)and 100.0%(40/40), respectively.The sensitivity and specificity of T3 and T4 stage for oral contrast-enhanced ultrasonography reached to 100.0%.The diagnostic accuracies of N0, N1-N3, M0 and M1 by oral contrast-enhanced ultrasonography were 95.0%(38/40), 95.0%(38/40), 100.0%(40/40)and 100.0%(40/40).@*Conclusions@#Oral contrast-enhanced ultrasonography is a simple, painless and non-invasive method for the diagnosis of gastric tumors in the elderly.And its qualitative coincidence rate of the tumors diagnosis is similar to that of gastroscopy.So it can be used as the first choice for the examination of gastric tumors in the elderly.Oral contrast-enhanced ultrasonography has a high diagnostic accuracy on TNM staging of gastric tumor.When combined with electronic gastroscopy, it may provide a more reliable basis for the choice of evaluation of treatment and prognosis in elderly patients with gastric tumor.
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Objective To investigate the diagnostic value of ultrasonography.in elderly patients with gastric tumors.Methods A total of 42 elderly patients with gastric tumors confirmed by surgery pathology underwent oral contrast-enhanced ultrasonography and electronic gastroscopy.The diagnostic effect of oral contrast-enhanced ultrasonography and electronic gastroscopy were compared based on the gold standard of surgical pathology.Results Of the 42 elderly patients with gastric tumors,40 patients were diagnosed by oral contrast-enhanced ultrasonography and the surgical pathology(40/42,95.2％),with Kappa value of 0.812.And 38 cases were diagnosed by electronic gastroscopy and the surgical pathology(38/42,90.5 ％),with Kappa value of 0.718 (P ＜ 0.05).Based on gold standard of surgical pathology results,the accuracies of T1,T2,T3 and T4 stage by oral contrast-enhanced ultrasonography were 95.0％ (38/40),95.0％ (38/40),100.0％ (40/40) and 100.0％(40/40),respectively.The sensitivity and specificity of T3 and T4 stage for oral contrastenhanced ultrasonography reached to 100.0 ％.The diagnostic accuracies of N0,N1-N3,M0 and M1 by oral contrast-enhanced ultrasonography were 95.0 ％ (38/40),95.0 ％ (38/40),100.0 ％ (40/40) and 100.0％(40/40).Conclusions Oral contrast-enhanced ultrasonography is a simple,painless and non-invasive method for the diagnosis of gastric tumors in the elderly.And its qualitative coincidence rate of the tumors diagnosis is similar to that of gastroscopy.So it can be used as the first choice for the examination of gastric tumors in the elderly.Oral contrast-enhanced ultrasonography has a high diagnostic accuracy on TNM staging of gastric tumor.When combined with electronic gastroscopy,it may provide a more reliable basis for the choice of evaluation of treatment and prognosis in elderly patients with gastric tumor.
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Objective To evaluate the value of endorectal ultrasound(ERUS)combined with real-time elastography in the staging of advanced rectal cancer in elderly patients.Methods A total of 50 patients with advanced rectal cancer underwent endorectal ultrasound and real-time tissue elastography imaging at our hospital from Jun.2014 to Oct.2015.Their staging results were compared with postoperative pathology.Results The accuracy,sensitivity and specificity of ERUS in the staging of advanced rectal cancer(T3)were 90％ (45/50),93.5％ (43/46)and 50％ (2/4),respectively.The accuracy,sensitivity and specificity of real-time elastography in the staging of advanced rectal cancer(T3)were 84％(42/50),89.1％(41/46)and 25％(1/4),respectively.With the combination of the two techniques,the accuracy,sensitivity and specificity in the staging of advanced recta[cancer(T3)were 96％ (48/50),97.8％ (45/46)and 75％ (3/4),respectively.There was no significant difference in accuracy and sensitivity(x2 ＝4.000 and 3.100,P＝0.373 and 0.542)between the three approaches.Kappa values between each of the three approaches and surgical pathology were 0.531,0.252 and 0.728,respectively.Conclusions Real-time tissue elastography in the diagnosis and staging of advanced rectal cancer can be enhanced when used in combination with endorectal ultrasound.
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Objective To explore the applicative value of contrast enhanced ultrasound (CEUS) through rectumin the T-staging of rectal cancer.Methods 24 cases with rectal cancer were examined preoperatively by endorectal ultrasound (ERUS) and CEUS during May 2012 to November 2013 in our hospital.The characteristics of contrast enhanced ultrasound imaging in early and late phase of the rectal cancers were studied,and the imaging distribution and enhancement mode were observed.The preoperative staging diagnosis was conducted by consulting T staging criteria.The diagnostic results were compared with the postoperative pathologic diagnosis.Results The contrast enhanced time in rectal cancer began at 14-35s.The early tumor showed uneven nodular,ribbon or ring in high enhancement.At the advanced late,angiographic tumor showed homogeneous enhancement and continued to be observed during the whole time.Normal rectal wall ultrasonography showed spotty low enhancement or no enhancement.The overall accuracy of ERUS in T-staging was 66.7％ (16/24) and the overall accuracy of CEUS was 83.3％ (20/24) respectively.There was a significant difference in the overall accuracy between ERUS and CEUS (P＝0.018).The sensitivity,accuracy and positive predictive value of CEUS were 100.0％ (2/2),100.0％ (2/2),100.0％ (2/2) inT1 stage,83.3％ (10/12),83.3％ (10/12),100.0％ (10/10) in T2 stage,100.0％ (8/8),88.9％ (8/9),88.9％(8/9) in T3 stage,and 100.0％ (2/2),100.0％(2/2),100.0％ (2/2) in T4 stage,respectively.Conclusions As compared toroutine transrectal ultrasound,transrectal contrast enhanced ultrasound imaging on rectal cancer shows the typical sonographic characteristic imaging on microvascular focus size and borders,on characteristic infiltration zone.Therefore,contrast enhanced ultrasound improves the diagnostic accuracy of preoperative T-staging in rectal cancer surgery.
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Objective To analyze ultrasonic elastography (UE) score of breast carcinoma and to explore the correlation between UE and pathological collagen content in stroma.Methods UE scores of 60 breast carcinoma before operation were retrospectively studied.The correlation between the UE scores and the pathological collagen content grading in stroma after operation were analyzed.Results UE score of 60 breast carcinoma were (4.07 ± 0.78) scores,the diagnosis coincidence rate of UE score was 80.0％ (48/60).Positive correlation existed between UE score and the pathological collagen content grading in stroma of breast carcinoma (r =0.440,P =0.015).Conclusion UE score of breast carcinoma is related to the pathological collagen content in stroma,and it can evaluate collagen content in stroma of breast masses in some degree.
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To explore the value of local anesthesia under ultrasonic guidance for establishing puncture path of superficial tumor.A total of 144 patients with superficial tumor received local pre-puncture anesthesia under ultrasonic guidance so that all lesions were targeted.Transient aggregation of narcotics was applied for raised (n =12) or superficial (n =15) skin lesions.The clarity of scanning acoustic window was enhanced,the puncture distance of tumor broadened and the mass of axial changed to obtain a longer lymph node cortex.The damage of blood vessels occurred easily due to tumor closeness to large blood vessel or shortened puncture path in 17 cases.Anesthetic drug was injected between tumor and blood vessels to enlarge the thickness for visualizing the puncture needle tract clearly.And puncture was accomplished under the guidance of color Doppler.Therefore a puncture path can be created effectively with local anesthesia by ultrasonic guidance.
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The aim of this study is to evaluate the application of untrasound-guided local anesthesia in alleviation of pain after percutaneous liver biopsy.The clinical results of 1417 cases of percutuneous liver biopsy were retrospectively analyzed.In 896 patients under ultrasound-guided local anesthesia 51 felt pain after liver biopsy,while in 521 patients whose local anesthesia without ultrasound guidance,143 felt pain (5.7% vs.27.4%,X~2=118.63,P＜0.01).The results indicate ultrasound-guided local anesthesia can effectively alleviate pain after percutaneous liver biopsy.
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Objective To study changes in the expression levels of OX-62, OX-6 and CD86 of mononuclear cells and the related chemotatic factor macrophage inflammatory protein-1α (MIP-1α) in the livers of rats with Walker-256 tumors treated with radiofrequency ablation (RFA) and to elucidate the influence of RFA on differentiation and migration of liver dendritic cells(DCs).Methods Walker-256 liver tumors were induced in 60 SpragueDawley rats by implanting tumor particles. These rats were randomly divided equally into three groups from which liver tissue around the local area of the tumor was sampled at 7 d and 14 d after RFA. The mononuclear liver cells were separated with Ficoll density gradient centrifugation. The expression levels of OX-62, OX-6 and CD86 in the mononuclear cells were analyzed with flow cytometry. The expression level of MIP-1α in the liver tissue was detected by enzyme-linked immunosorbent assay (ELISA). Results The average expression of OX-6 in the control rats was 15.29 ±4.59% and those 7 d and 14 d after RFA were 34.20±11.62% and 39.18±9.14% respectively. The difference between the two RFA groups and the control group was statistically significant. The average expression rate of OX-62 in the control rats was 18.91±4.58% and those 7 d and 14 d after RFA were 24.49±4.45% and 22.77 ± 3.50% respectively. The difference between the 7 d group and the control group was significant. The average expression rate of CD86 in the control rats was 66.29±17.69% and those 7 d and 14 d after RFA were 55.29±10.69% and 55.93±12.64% respectively. These differences between both RFA groups and the controls group were not significant. The average expression level of MIP-1 α around the tumors was 232.92±54.58 pg/ml in the controls and 499.38±15.14 pg/ml and 495.90±9.94 pg/ml 7d and 14 d after RFA respectively. These differences from the controls were both statistically significant. Conclusion The expression of MIP-1α around the tumors was elevated after RFA, which could promote the migration of DCs. The changes in the expression of OX-62, OX-6 and CD86 also could reflect increased DC differentiation, which could improve local antigen-presenting capacity to a certain extent and recovery of host anti-tumor immune response.
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BACKROUND:Previous studies have confirmed that radiofrequency ablation(RFA)has not only efficiently killed tumor cells,but also improved immune suppression of organism.Antigen presenting cells play an important role during anti-tumor immune reaction.Dendritic cells are most powerful antigen presenting cells.OBJECTIVE:To study the influence of RFA on OX-62,OX-6 and CD86 expression of rat peripheral blood mononuclear cells.DESIGN,TIME AND SETTING:The randomized controlled animal observation was performed at the School of Oncology of Peking University from June 2005 to March 2006.MATERIALS:A total of 12 Sprague Dawley rats were equally and randomly assigned into control and 1 -week radiofrequency groups.METHODS:2 mL peripheral blood was extracted from rats of the control group following rats were sacrificed.The left lobe of rat liver was exposed,inserted with acicular electrodes at tilted position.The acicular electrodes were spread out.The action time was 4 minutes.After RFA,the rats were given anti-infective therapy.2 mL peripheral blood was taken out after they were put to death 1 week after RFA.MAIN OUTCOME MEASURES:The following parameters were measured:pathomorphological observation on the liver of normal rats after RFA;OX-62,OX-6 and CD86 expression of peripheral blood mononuclear cells before and after RFA.RESULTS:Pathologyical examination after RFA showed the characteristic that coagulation necrosis and cellular degeneration and granulation tissue forming appeared from target center to peripheral of the target.Positive expression rate of OX-62 in rat peripheral blood in the 1-week radiofrequency group[(0.70±0.16)%]was significantly higher than in the control group [(0.34±0.08)%,P ＜0.05].No significant difference in positive expression rate of OX-6 and CD86 in the peripheral blood mononuclear cells between both groups(P＞0.05).CONCLUSION:RFA can promote the increased number of precursor Dendritic cells in rat peripheral blood,which may be contributed to improve the ability to angtigen presentation during immune response.Dai Wei-de,Doctor,Associate chief physician,Department of Ultrasound,Beijing Hospital of Ministry of Public Health,Beijing 100730,China dai.weide@126.com
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Objective To study the change of spleen Dendritic cells in normal rats treated by radio-frequency ablation(RFA). Methods Eighteen healthy SD rats were separated into group 1 week after RFA with 6 rats,group 2 week after RFA with 6 rats and control group with 6 rats. Spleen tissue were taken out respectively before RFA, 1 week after RFA and 2 weeks after RFA. The number and the phenotype of Dendritic cells in spleen were analyzed with flowcytometry. Results Pathologyical examination after RFA showed the characteristic that coagulation necrosis and cellular degeneration and granulation tissue forming appeared from target center to peripheral of the target. (10. 36±3. 21) % of normal rat mononuclear cells in spleen express OX-62, the ratio became (18. 03±5. 7) % 1 week after RFA and (12. 63±8. 0) % 2 weeks after RFA, the difference between group 1 week after RFA and control group was marked. (76. 33±7. 86) % of normal rat mononuclear cells in spleen express OX-6,the ratio became (78.33±7.25)% 1 week after RFA and (86. 04±7. 25) % 2 weeks after RFA, the difference between group 2 weeks after RFA and control group was marked. (63. 06±8. 77) % of normal rat mononuclear cells in spleen express CD86,the ratio was (55. 74±14. 49)% 1 week after RFA and (63.49±11.81)% 2 weeks after RFA,the difference between groups 1 week or 2 weeks after RFA and control group was not marked. Conclusions RFA can increasing the number of precursor Dendritic cells migrating from peripheral blood to spleen, and those cells may furtherly differentiate or maturate, which may be contributed to improve the ability delivery of body to antigen to a certain extent.
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Objective To investigate the changes of chemokines related to dendritic cells in liver and spleen in rats with hepatic carcinoma treated by radiofrequency ablation (RFA),and to explore the mechanism of anti-tumor responses to RFA.Methods Forty healthy SD rats with established animal model of hepatic carcinoma were randomly divided into control group (n=10),RFA 7d group (n=16) and RFA 14d group (n=14).The rats of control group were killed without treatment.The other rats were killed in 7d and 14d after RFA treatment respectively.Spleen and liver tissue around the ablation area or around the tumor were taken out.The expressions of macrophage inflammatory protein (MIP)-1a in liver tissue and MIP-3β in spleen were analyzed by ELISA.Results The expression of MIP-1a in liver tissue was (232.92±54.5B)ng/L in control group,which enhanced to (499.38±15.14)ng/L and (495.90±9.94)ng/L in RFA 7d and 14d groups respectively.There were significant differences between control and RFA 7d group,control and RFA 14d group(P＜0.05).The expression of MIP-3βin spleen was (70.08±2.67) ng/L in control group,which enhanced to (151.57±48.48)ng/L and (154.57±18.25)ng/L in RFA 7 d and 14 d groups respectively.There were significant differences between control and RFA 7 d group,control and RFA 14 d group (P＜0.05).Conclusions The expressions of MIP-1a in liver tissue and MIP-3β in spleen increase significantly after RFA.These changes will promote recruitment and migration of dendritic cells and may contribute to the anti-tumor responses after RFA.
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Objective To investigate the change of dendritic cells (DCs) in rats with hepatic carcinoma treated by radiofrequency ablation (RFA),and to explore the mechanisms of anti-tumor immune response to RFA. Methods Forty healthy SD rats with established animal model of hepatic carcinoma were randomly divided into control group (n = 10) ,RFA 7 d group (n = 16) and RFA 14 d group (n = 14). The rats of control group were killed without treatment. The other rats were killed in 7 d and 14 d after RFA treatment respectively. Peripheral blood, liver tissue around the ablation area and spleen were taken out. The OX62,OX6,CD86 of DCs were analyzed with flowcytometry. Results ①OX62 cells accounted for (0.45 ± 0.19)% of mononuelear cells in peripheral blood in control group. The account of OX62 cells increased to (0.78 ± 0.30)% and (1.53 % 0.80)% in RFA 7 d and 14 d groups respectively. There were significant differences between control and RFA 7 d group, control and RFA 14 d group (P<0.05). ②OX62 cells accounted for (18.91 ± 4.58)% of mononuclear cells in liver tissue around the tumor in control group. The account of OX62 cells increased to (24.49 ± 4.59)% in RFA 7 d group (P<0.05). The expression of OX6 on DCs in liver tissue was (15.29 ± 4.59)% and increased to (34.2 ± 11.62)% and (39.18 ± 9.14)% in RFA 7 d and RFA 14 d group respectively (P<0.05). ③OX62 cells accounted for (11.69 ± 4.39)% of mononuclear cells in spleen in control group which increased to (15.10±2.37)% in RFA 14 d group (P<0.05). Conclusions The precursor DCs in peripheral blood and DCs in liver and spleen increased significantly after RFA. The expressions of OX6 on DCs in liver and spleen increased after RFA. RFA can promote the differentiation and maturation of DC. The increased function of antigen presenting may contribute to the anti-tumor responses after RFA.
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Objective To discuss the change of serum TGF-β1 and IL-10 in peripheral blood of rats with liver tumor treated by RFA.Methods Thirty experimental liver tumor model of SD rats were prepared by implantation of tumor particles.These rats were randomly divided equally into three groups including 1 week after RFA,2 week after RFA and control group.Peripheral blood of control group,group 1 week after RFA and group 2 week after RFA was taken out respectively without RFA,1 week and 2 week after RFA.The mononuclear cells of peripheral blood were separated by Ficoll density gradient centrifugation.The expression level of IL-10 in peripheral blood was analyzed with flowcytometry.Serum TGF-β1 were dectected by ELISA.Results The serum expression level of TGF-β1 of control group was(6.61±0.12)μg/L,and that of group 1 week and 2 week after RFA were respectively(5.63±0.46)μg/L and(5.53±0.56)μg/L.There was statistical significance for the difference between control group and group 1 week or group 2 week after RFA.The serum expression level of IL-10 of control gorup was 95.92±2.31,and that of group 1 week and 2 week after RFA were respectively 89.71±5.44 and 87.67±11.11.There was statistical significance for the difference between control group and group 1 week after RFA.Conclusions RFA can destroy the tumor tissues in situ and relief immune suppression by IL-10,TGF-β1 secreted by tumor tissue.RFA can improve differentiation and maturation of dendritic cell in local area of tumor and promate ability of antigen-presentation of body.
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Objective To dynamically observe photodamage of subcellular sites by use of laser scanning confocal microscopy (LSCM). Methods The samples were divided into four groups. Murine lung endothelial cells were subcultured and incubated with HMME for 24 hours. Then the cells were stained with rhodamine-123 for demonstration of mitochondria. LSCM was applied and organelle-cell fluorescence intensity ratio analysis was adopted to study the intracellular distribution of HMME. Then dynamic fluorescence images sequence of rhodamine-123 was collected. Results Rhodamine-123′s fluorescence images of cell sample with HMME was changed gradually during irradiation: the typical characteristic of mitochondria disappeared gradually with decreasing fluorescence intensity. The fluorescence of rhodamine-123 was diffused and distributed in nuclear, while rhodamine-123′s fluorescence images of cell sample without HMME was not changed. Conclusion Mitochondria and nucleus are photodamage sites by HMME-PDT; LSCM can be applied in dynamic observation of photodamage of subcelluar sites.
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Objective To compare and evaluate Organelle-cell fluorescence intensity ratio analysis established in this study with other techniques to determine the subcellular localization of photosensitizers. Methods CCD fluorescence microscopy imaging system was applied and a kind of special organelle probe BODIPY was selected to label Golgi body. Directly observing, pseudo-color fusing, wave-shape comparing, correlation coefficient calcula-ting and Organelle-cell fluorescence intensity ratio analysis were adopted, respectively, to study the intracellular distribution of domestic photosensitizer Hematoporphyrin monomethyl ether (HMME). Results Fluorescence distributing modes of HMME and BODIPY were similar with each other. There ware yellow space-overlap areas in the fusion image. Wave body of changing curve of gray scale value of all pixels in the straight line in two images corresponding to space coordinate was similar with each other. Correlation coefficient in each pixel between fluorescence intensity of HMME and that of BODIPY was 0.602 4. With increasing of parameter m, namely degree of organelles congregated reducing, the average fluorescence intensity ratio (J_1/J_2) of Golgi complex was decreasing, the two parameters po-ssessed obvious relativity. P