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1临床资料 患者，女，48岁，因咳嗽、咳痰半月入院。入院查体：神志清，浅表淋巴结未触及肿大，双肺呼吸动度均等，叩诊两侧清音，双肺呼吸音粗，可闻及少量干湿啰音，未闻及胸膜摩擦音。CT检查示：右肺门增大并软组织密度影，纵隔内多发淋巴结肿大。纤支镜未查见癌细胞。入院后第3天突然出现言语不清，面瘫、舌瘫，左侧肢体无力，肌力约3—4级。

患者 男性， 60岁，因发现颈部肿物伴腹痛1月余于2005年2月12日入院。患者于1月前出现颈部肿物，并呈进行性增大伴轻度疼痛，伴腹痛。 无咳嗽及咯血丝痰史。入院查体：一般生命体征稳定。双侧颈部，左锁骨上，右腋下，双侧腹股沟可触及多个肿大淋巴结。

患儿，男，11岁，因“反复右侧胸腔积液9年”入院。9年前因胸闷、气短、喘息、口唇颜面发绀，就诊于西安市儿童医院，诊断为“右侧胸腔积液”，并给予穿刺抽液后好转出院。后胸腔积液反复发作。查体：体温正常，双测腋窝内可触及2～3个肿大淋巴结，右肺呼吸音消失，未闻及干湿罗音。辅助检查：PPD(-)，肺吸虫试验(-)，胸片：右侧胸腔中量积液，纵膈淋巴结肿大，右下肺不张。胸CT：右前上纵膈肿块，密度均匀，边界清楚，病灶内有类圆形钙化灶，考虑纵膈肿瘤、畸胎瘤可能。手术探查：前纵膈巨大囊性肿瘤，

患者 女，65岁，3年前因发现腹擘进行性增大包块1个，约2cm×2cm，质硬，活动．无压痛，于门诊行包块切除术，术后病理检查示转移性腺癌，行B超、CT等相关辅助检查未发现原发病灶。2月后包块再发，伴疼痛，再次行包块并腹膜切除，术后恢复好。半年前因刺激性干咳3个月入院，CT检查显示：右肺包块，纵隔淋巴结肿大；纤维支气管镜检右肺下叶后基底段开口刷片查见腺癌细胞。其余检查未见异常。患者因经济困难放弃治疗，之后失访。

Severe fever with thrombocytopenia syndrome （SFTS） is an emerging hemorrhagic fever in rural areas of China and is caused by a new bunyavirus, SFTSV, named after the disease. The transmission vectors and animal hosts of SFTSV are unclear. Ticks are the most likely transmission vectors and domestic animals, including goats, dogs, and cattle, are potential amplifying hosts of SFTSV. The clinical symptoms of SFTS are nonspecific, but major symptoms include fever, gastrointestinal symptoms, myalgia, dizziness, joint pain, chills, and regional lymphadenopathy. The most common abnormalities in laboratory test results are thrombocytopenia （95%）, leukocytopenia （86%）, and elevated levels of serum alanine aminotransferase, aspartate ami- notransferase, creatine kinase, and lactate dehydrogenase. The fatality rate for SFTS is 12% on average, and the annual inci- dence of the disease is approximately five per 100000 of the rural population.

Oral squamous cell carcinoma （OSCC） has a high incidence of cervical micrometastases and sometimes metastasizes contralaterally because of the rich lymphatic intercommunications relative to submucosal plexus of oral cavity that freely communicate across the midline, and it can facilitate the spread of neoplastic cells to any area of the neck consequently. Clinical and histopathologic factors continue to provide predictive information to contralateral neck metastases （CLNM） in OSCC, which determine prophylactic and adjuvant treatments for an individual patient. This review describes the predictive value of clinical-histopathologic factors, which relate to primary tumor and cervical lymph nodes, and surgical dissection and adjuvant treatments. In addition, the indications for elective contralateral neck dissection and adjuvant radiotherapy （aRT） and strategies for follow-up are offered, which is strongly focused by clinicians to prevent later CLNM and poor prognosis subsequently.

Background： Diagnosis of syphilis is difficult. Follow-up and therapy evaluation of syphilitic patients are poor. Little is known about positron emission tomography （PET） in syphilis. This review was to systematically review usefulness of PET for diagnosis, disease extent evaluation, follow-up, and treatment response assessment in patients with syphilis. Methods： We searched PubMed, EMBASE, SCOPUS, Cochrane Library, Web of Science, ClinicalTrials.gov, and three Chinese databases （SinoMed, Wanfang, and CNKI） for English and Chinese language articles from inception to September 2016. We also collected potentially relevant studies and reviews using a manual search. The search keywords included the combined text and MeSH terms ＂syphilis＂ and ＂positron emission tomography＂. We included studies that reporting syphilis with a PET scan before and/or after antibiotic treatment. The diagnosis of syphilis was based on serological criteria or dark field microscopy. Outcomes include pre- and post-treatment PET scan, pre- and post-treatment computed tomography, and pre- and post-treatment magnetic resonance imaging. We excluded the articles not published in English or Chinese or not involving humans. Results： Of 258 identified articles, 34 observational studies were included. Thirty-three studies were single-patient case reports and one study was a small case series. All patients were adults. The mean age of patients was 48.3 ~ 12.1 years. In primary syphilis, increased fluorodeoxyglucose （FDG） accumulation could be seen at the site of inoculation or in the regional lymph nodes. In secondary syphilis with lung, bone, gastrointestinal involvement, or generalized lymphadenopathy, increased FDG uptake was the most commonly detected changes. In tertiary＇ syphilis, increased glucose metabolic activity, hypometabolic lesions, or normal glucose uptake might be seen on PET. There were five types of PET scans in neurosyphilis. A repeated PET scan after treatment revealed apparent or complete resolution of the asymmetry of radiotracer uptake. Conclusion： PET is helpful in targeting diagnostic interventions, characterizing disease extent, assessing nodal involvement, and treatment efficacy for syphilis.

Dear Editor,Kikuchi-Fujimoto disease（KFD）,or histiocytic necrotizing lymphadenitis,was initially described in 1972 by Drs.Kikuchi and Fujimoto（Shirakusa et al.,1988）.The main clinical manifestations are fever and cervical lymphadenopathy with or without pain,sometimes accompanied by tachycardia,nausea and symptomatic infiltrative erythematous lesions.The diagnosis of KFD is usually based on characteristic lymph node histologic findings of coagulative necrosis,histiocytic infiltrate,loss of nodal architecture,

To the Editor： A 44-year-old man with no remarkable past medical history, was admitted with I-month history of fever and lymphadenopathy. He also had night sweats, malaise. arthralgia, urine volume reduction, abdominal distention, and weight loss. Physical exainination revealed swollen lymph nodes in the neck, axillary fossae and inguinal grooves, palpable liver and spleen, shifting dullness and edema.

To the Editor： A 20-year-old woman complained of two painful pruritic lesions on her left index finger. She had been bitten by a lamb on her index finger a month earlier; the lamb died 2 days later. Five days after having been bitten, she noticed two papules on her left index finger that enlarged gradually. Physical examination revealed two indurated nodules 8-mm and 10-mm in diameter, each with central umbilication and surrounded by a reddish halo [Figure i a]. The patient had no fever, respiratory symptoms, or lymphadenopathy. The informed consent was written.