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ObjectiveTo investigate the CT and MRI imaging characteristics of autoimmune pancreatitis and its clinical value.MethodsFourteen patients(13males, 1female, mean age 58.3 years) with autoimmune pancreatitis proved histopathologically or clinically were enrolled in the study.Clinical data was studied retrospectively.Among those patients,CT was performed on 12 cases and MR imaging was performed on 8 patients,6 patients underwent both CT and MR imaging.ResultsAll 14 patients had enlargement of the pancreas,which could be divided into three types including diffuse type ( n =7 ),focal type ( n =5 ) and mixed type ( n =2 ).On plain CT the pancreas was of isodensity ( n =5 ) or mild hypodensity ( n =7).In one case there was several small hypodensity cystic lesions within and around the pancreas that was rarely seen in other autoimmune pancreatitis cases.Pancreatic lesions as shown by MRI were all mildly hypointense on T1WI and mildly hyperintense on T2WI,all displayed lesions were detected as high-signal intensity areas on DWI. By medium contrast,autoimmune pancreatitis lesions demonstrated “ snow-like” heterogeneously decreased enhancement on artery phase of dynamic contrast enhanced imaging and then showed gradually delayed enhancement on portal venous phase and later phases.“Capsule-like” rim was present around the autoimmune pancreatitis lesions in 9 cases.Main pancreatic duct was irregular in shape in 4 cases and slightly dilated in 5 patients.Strictures of lower common bile duct and upper bile duct dilatation as well as thickening and enhancement of the bile duct wall were found in 9 cases.Peripheral vascular involvement was seen in 4 cases. Abdominal lymphadenopathy at hepatic portal was observed in 1 patient.Two cases showed tiny decreased enhancement lesions in the kidneys.Steroid therapy was given in 10 cases,all pancreatitis lesions ameliorated as showed by follow-up imaging examinations.ConclusionsAIP specific CT and MRI imaging findings are common in most patients which help establish the diagnosis and differential diagnosis of AIP.
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Objective To analyze indications,complications and outcomes of amputation.Methods A total of 15 patients undergone amputation in field or at tent hospital were collected for analy-zing injury severity,place where amputation was done,whether open or closed amputation and stitch re-moval time. Results There were 9 males and 6 females.at an average age of 32 years(11-51years).There were 16 amputations including Gustilo IIIB in 2 patients, Gustilo IIIC in 9 and Tscheme Ⅲin 5 according to Gustiln classification or Tscheme classification.Four patients who received amputation in field or at tent hospital developed infection and had to receive amputation again at a higher level on the limb and drainage of open wounds because of a higher infection rate due to the amputation location.Ten patients received first amputation at higher levels with open wound at station hospital but only 2 manifested infected incision.High level amputation with one stage closure was done in 1 patient who was infected and suppurated after operation and even developed bacteremia. Conclusions Infection rate following am-putation 4n field and tent clinics is rather higher,so secondary open amputations should be performed at a higher level as soon as possible.One-time and high-level open amputation plays an important role in treat-ment of severe lower limb injuries following earthquake.
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PurposeTo establish sensitive and reliable serum marker on liver fibrosis for early clinical diagnosis. MethodsSerum hyaluronate acid,type Ⅲ procollagen and type Ⅳ procogen of 48 patients with viral hepatitis were analyzed by radioimmunoassay and ELISA respectively. ResultsThe serum HA, PCⅢ and PCⅣ level increased gradually with the progress of the disease. Their levels were correlated distinctly with the index of hepatic activity of inflammation and that of fibrosis.ConclusionsThe value of serum HA,PCⅢ and PCⅣ in predicting liver fibrosis will be enhanced ff the effect of inflammation could be excluded.
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Objective To discuss the feasibility of computerized tomography (CT) calibration technique for the quantification of the hepatic fat content in vivo . Methods Eleven healthy volunteers, 53 patients with fatty liver, 10 cases of chronic hepatitis B and 10 cases of liver cirrhosis were tested with CT calibration test tubes. Test tubes contained solutions with Terbutyl alcohol, which CT scan density (CTD) is close to fat tissue, and 18.5% glucose solution which CTD is almost identical to normal liver. Variable Terbutyl concentrations of 10%, 20%, 30% and 40%, which stands for various fat content in liver, were used to measure patients with variable degrees of steatosis under CT scan. Results There was a negative linear correlation ( r = -0.982 , P
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Objective Based on the liver biopsy samples in the past 10 years, this study aimed to investigate the incidence of fatty liver, the relationship among fatty liver and other underlying liver diseases, the clinical and pathological characteristics and the risk factors of fatty liver. Methods In the total 658 cases of liver biopsy from 1988 to 1997, there were 71 cases of fatty liver, among them 68 cases were nonalcoholic fatty liver. Matched by sex and age, 155 cases of non fatty liver cases were taken as control. All cases had had the tests of liver function, blood lipid profile, blood glucose and hepatitis virus markers. Liver biopsy samples were investigated by pathologists. Results The incidence of fatty liver among all the liver biopsy cases was 10.8%. The patients' ALT, AST, TB and CB levels in fatty liver group were significantly lower than in non fatty liver group ( P
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Purpose To understand the clinical significance of sequence variations in the hypervariable region(HVR) of hepatitis C virus during infections. Methods 8 cases of acute hepatitis C and 20 of chronic hepatitis C were followed for two years.Blood samples were taken at intervals of six months for analysis of HCV?HVR sequences by reverse transcription-polymerase chain reaction(RT?PCR) and direct sequencing methods. Results Results showed that HCV?HVR sequences of the 28 patients changed in various degrees.92% of these nucleotide substitutions led to changes of corresponding amino-acid sequences.Only 8% of changed nucleotide were synonymous substitutions.Variation of amino acid ranged from 1 to 20(mean 8,30%).The most common nucleotide substitution(62%) occurred in the first position of codon,31% in the second and the rest in the third.HVR variation rate was 0.89×10-1 per genome site per year in acute hepatitis C,compared with 2.31×10-1 per genome site per year in chronic hepatitis C (P<0.05),but variations had no relation to HCV subtype.Variation of HVR in the flare up type (ALT>150 u/L) was much more than that in the quiescent type (ALT<100 u/L). Conclusions Our results suggested that sequence variation of HVR during HCV chronic infection seems to be an adaptive response to HCV to evade the host immune pressure and might play a major role in the establishment of persistent infection as well as in the flare-up of hepatitis.