ABSTRACT
Objective Toevaluatethediagnosticvalueof1.5T multiparametricmagneticresonanceimaging (mpMRI)scoring systeminearlycentralprostatecancer(PCa).Methods DataofpatientswhoreceivedprostatempMRIfromJune2014toJune2016 wereanalyzedretrospectively.AccordingtoProstateImagingReportingandDataSystem Version2 (PIGRADS V2),a5Gscorescale wasadoptedandthetwoassociateradiologists,whowereblindedtoanyclinicaldetails,interpretedMRimages.Withthepathological resultsasthediagnosticgoldstandard,theROCcurvewasplottedandtheAUCwascalculated.Thediagnosticsensitivity,specificity, positivepredictivevalueandnegativepredictivevalue,accuracyofPCawerecalculatedunderdifferentdiagnosticthresholds(score3 or4).Results Atotalof41patientswereincludedinthestudyoutofwhich15caseswerethosewithPCaand26caseswithbenign prostatichyperplasia(BPH).TheAUCwas0.733(P＝0.014).Onthediagnosticthresholdscoreof3and4,thesensitivity,specificity, positivepredictivevalue,negativepredictivevalueandaccuracywere73.33%vs40%,61.54%vs92.31%,52.38%vs75%,80%vs 72.73%and65.85%vs73.17%respectively.Conclusion The1.5T mpMRIscoringsystemisrelativelyareliabletechniquefordetecting earlyPCainthecentralglandarea.PatientscanbefollowedGupwithprostatespecificantigen(PSA)whenthescoreislessthan3,and ascoreof4ormoreishighlysuggestiveofPCa.
ABSTRACT
Objective To investigate the characteristics of esophageal motility in patients with type Ⅱ achalasia and evaluate the clinical value of high resolution manometry (HRM).Methods A total of 20 patients with type Ⅱ achalasia(observation group) and 15 healthy controls(control group) were enrolled for high resolution manometry.The characteristics of esophageal motility of two groups were compared.Results The motor pattern of esophageal body of observation group was mostly non-conductive synchronous contraction(88.2％,176/200),but in control group it was normal esophageal peristalsis.Lower esophageal sphincter pressure,4 s integrated relaxation pressure(4s IRP) and upper esophageal sphincter residual pressure in observation group were (37.6 ± 12.8)mmHg,(31.5 ± 13.4)mmHg and (14.0 ± 3.8)mmHg,respectively,which were higher than those ot the control group,(23.7 ± 5.6) mmHg(t =3.925,P =0.000),(10.5 ±4.3) mmHg(t =5.835,P =0.000) and (7.9 ± 4.5) mmHg (t =4.325,P =0.000).The lower esophageal sphincter relaxation rate in observation group was(23.6 ± 19.6)％,which was lower than that of the control group(58.1 ±16.7)％ (t =-5.491,P =0.000).There was no significant difference in lower esophageal sphincter length and upper esophageal sphincter pressure between type Ⅱ achalasia group and control group (P ＞0.05).Conclusion The characteristics of esophageal manometry in type Ⅱ achalasia is non-conductive synchronous contraction and elevated 4s IRP,and HRM contributes to early diagnosis,reclassification and evaluation of expected outcome in achalasia.
ABSTRACT
Objective To explore the correlation between the length of peristaltic break (LPB) and the severity of the symptoms in patients with non-erosive reflux disease (NERD) and negative pH monitoring.Methods A total of 35 patients with NERD and negative pH monitoring were enrolled,and at same time 10 healthy individuals were selected as controls.The LPB of esophageal body of both groups was measured by high resolution manometry (HRM).Meanwhile,the symptom of NERD patients with negative pH monitoring was scored.The LPB of esophageal body between the two groups was compared by t test.The correlation between the LPB and the severity of the symptoms in NERD patients with negative pH monitoring was analyzed by Pearson correlation analysis.Results The average LPB of esophageal body of NERD patients with negative pH monitoring was (3.3±0.9)cm,which was longer than that of healthy controls ((1.2 ± 0.4) cm),and the difference was statistically significant (t=9.17,P＜0.01).The symptom score of NERD patients with negative pH monitoring was 21.6± 7.8.There was a positive correlation between the LPB and NERD symptom score (r=0.894,P＜ 0.01).Conclusion The LPB of esophageal body is a kind of expression of esophageal motility dysfunction,which is correlated with the symptom of NERD.
ABSTRACT
Objective To investigate esophageal high-resolution manometry (HRM) combined with 24-hour pH monitor in detecting endoscopy-negative chest pain of esophageal origin.Methods Test results of esophageal HRM combined with 24-hour pH monitor from 40 patients with recurring chest pain of esophageal origin were retrospectively analyzed.Results In 40 patients,27 (67.5％) were diagnosed as gastroesophageal reflux disease with an average DeMeester scores at 18.3 ± 3.4,including 19 patients with esophageal body dismotility and 11 with reduced lower esophageal sphincter pressure (LESP) at a mean reduction of 5.7 mm Hg.There were 6 cases (15.0％) of achalasia,in which 1 (2.5％) was type Ⅰ and 5 (12.5％)was type Ⅱ,with an average relaxation ratio of lower esophageal sphincter (RRLES) at (30.1 ± 2.3) ％.There were 4 cases of diffuse esophageal spasm (DES),with an average contraction frontal velocity (CFV) of 12.3 ± 2.4 cm ·s-1 and abnormal contraction waves in esophageal body,spontaneous synchronous contraction waves were observed in 3 of 4 patients LESP increased in 1 patient with DES and remained normal in other 3.RRLES decreased in 2 cases with DES and remained normal in other 2.There were 2 cases (5.0％)of nutcracker esophagus,with an average distal contractile integral at 6745.5 ± 175.2 mm Hg·cm-1 ·s-1 and an average CFV at 4.3 ±0.4 cm·s-1.There was 1 case (2.5％) with absence of esophageal peristalsis,with a low LESP at 2 mmHg and DeMeester scores at 38.3.The patient was finally diagnosed as systemic sclerosis according to esophageal biopsy and other auxiliary examination.Conclusion HRM combined with 24-hour pH monitor is valuable in detecting endoscopy-negative chest pain of esophageal origin.
ABSTRACT
Toassesstheeffectofpuerarinintreatingischemiacardiacdisease ,sixtycoronaryheartdisease(CHD) patientswith myocardialischemiawererandomlydividedinto 2 groups.Pueraringroup (30cases)wastreatedwithpuerarinpluswesternmedicine andcontrolgroup (30cases)withwesternmedicinealone .Thechangesofthetotalischemiaburden (TIB) ,ventricularpremature beat (VPB) ,heartrateandsystolicpressurelevelswereobservedbeforeandaftertreatmeat.Aftertreatmentwithpuerarinthe scoresofTIBlevelsweresignificantlydecreased (P 0 .0 5 ) .Thescoresofventricularprematurebeatlevelsweresignificantlydecreased (P