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Objective:To investigate the efficacy and safety of 125I seed implantation in the treatment of radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC). Methods:Fourteen patients (8 males, 6 females, age: (62.0±10.7) years) with RAIR-DTC confirmed by pathology or imaging examination in the Central Hospital of Wuhan, Tongji Medical College between July 2017 and March 2021, were retrospectively analyzed. The patients were treated with 125I seed implantation guided by CT. Ultrasound, CT, 125I-SPECT/CT or MRI were performed at 1.5, 3, 6 and 12 months after the implantation to evaluate the changes of lesion volume, and serum thyroglobulin (Tg), as well as symptom relief were monitored and recorded. The paired t-test was used for data analysis. Results:The 125I seeds were successfully implanted (16 operations) in 14 patients with 25 lesions. Patients were followed up for 3-44 months (median: 6.5(4.5, 11.5) months). The total effective rate was 60.0%(15/25) and the total local control rate was 96.0%(24/25). The effective rate for metastatic lymph nodes was 10/17, and the local control rate was 16/17. The effective rate and the local control rate for local recurrence were 1/3 and 3/3 respectively, and those for bone metastasis were both 3/3, those for sinus metastasis were 0/1 and 1/1 respectively, and those for lung metastasis were both 1/1. In 8 patients with clinical symptoms, symtoms of 4 cases were completely relieved, those of 3 cases were partially relieved and 1 case had no remission. The Tg level and the tumor length were both decreased after operation ((245.99±44.85) μg/L vs (330.38±50.78) μg/L, t=2.92, P=0.010; (2.71±0.34) cm vs (3.78±0.27) cm, t=3.13, P=0.007). Conclusions:125I seed implantation, as a supplementary treatment for RAIR-DTC, is safe and effective. It has a good effect against metastatic and local recurrent lesions.
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Objective To study the MRI findings and pathologic characteristics of cesarean scar pregnancy during the first-trimes-ter.Methods Clinical data,MRI findings and pathologic manifestations of 23 CSP patients confirmed by surgery and pathology were analyzed retrospectively.Results On pathologic specimens by the microscope,villi and decidua tissue were found in the myometrium of all 23 cases (100%),and smooth muscle tissue in the uterus scar was incomplete in 12 cases (52.2%).The incision scars were found in the uterine lower antetheca in 21 cases,which showed low signal on T1 WI and T2 WI.A majority of the gestational sac pro-truded into intrauterine in 12 cases.The gestational sac located in the scar of lower uterine antetheca in 10 cases and in the myometri-um around the scar in 1 case.The gestational sac of 22 cases were quasi-round with the size between 1.8 cm×1.2 cm and 6.4 cm× 2.7 cm.The gestational sacs showed homogeneous low signal on T1 WI and high signal on T2 WI in 8 cases,heterogeneous high signal on T2 WI and STIR sequence in 1 5 cases,a little short T1 signal of bleeding in 9 cases,and heterogeneous high signal on DWI sequence in 3 cases.The gestational sac borders were well-defined in 18 cases and blurred in 5 cases.Among 5 cases performed by enhanced MRI,there were 3 cases which gestational sac walls were ring-shaped enhanced.Conclusion MRI findings of CSP had certain char-acteristics and could reflect the pathological characteristics of CSP.MRI had important reference value in early diagnosis of CSP and the choice of treatment.
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Objective To evaluate the diagnostic value of multi-slice computed tomography (MSCT)for incisional hernia of ab-dominal wall before operations.Methods Thirty patients with incisional hernia in abdominal wall confirmed by the pathology were enrolled in this study.All patients underwent MSCT examination with sagittal and coronal MPRs,and 21 cases underwent ultra-sound (US)examinations.The value of transverse scan and MPRs & MSCT and US on demonstrating the number,location,con-tents of incisional hernia,and accompanying intestinal obstruction or other complications were retrospectively evaluated and com-paired.Results Of 30 cases,there were 40 hernias,the rate of MSCT and US in detecting incisional hernias were 97.5% and 56.0%, respectively.MSCT performed better than US on demonstrating the incisional hernias (P =0.000).On MSCT,there was no signif-icant difference in the detection for isolated incisional hernia between the MPRs and axial scans (P = 1.000 ).However,MPR showed a more accurate rate for two or multiple incisional hernias diagnosis (P =0.006),and the sagittal reconstruction displayed more correct than coronal reconstruction on two or multiple incisional hernias (P =0.01 9).Furthermore,MSCT can exactly reveal the complications of incisional hernias (7 cases of intestinal obstruction,5 cases of intestinal ischemia and edema,and 1 case of me-tastasis in incisional hernia),which were not detected by US.Conclusion MSCT can correctly demonstrate the incisional hernia of abdominal wall and its complication,it can provide important imaging reference for clinical therapy.
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PurposeTo evaluate multislice spiral CT (MSCT) in diagnosing abdominal anaphylactoid purpura (AAP), and to explore its role in treatment follow-up.Materials and Methods Clinical and MSCT data of 13 patients with confirmed AAP were retrospectively analyzed. All patients underwent abdominal CT scan and thin layer reconstruction. Upper endoscopy was performed in 8 patients prior to treatment. MSCT was performed in 10 patients and endoscopy in 4 patients posttreatment, then clinical and CT features were compared to pretreatment findings.Results In pretreatment CT scan, single segment bowel involvement was found in 2 cases, multisegmental bowel involvement in 10 cases, and no positive finding in 1 patient. The duodenum and jejunum were involved in 8 patients and stomach in 5 patients. The diseased bowel wall showed swelling and thickening with decreased attenuation and homogeneous luminal narrowing with equivocal lining and double loop sign. Infiltration was found in 10 patients, small ascites in 3 patients. Patients were misdiagnosed as acute pancreatitis in 2 cases, acute cholecystitis, small bowel obstruction and peritonitis in 1 case respectively. Of 13 patients, five patients were cured, and the other 8 patients were improved. The clinical symptoms including rash, abdominal pain, occult blood, leukocytosis, vomiting, melena, urine occult blood were improved (χ2=5.59-18.33,P0.05).Conclusion MSCT findings of AAP are nonspecific. CT diagnosis is difficult before skin rash. Combining CT characteristics of multisegmental bowel edema and clinical manifestations is helpful. CT examination can effectively follow up treatment response.
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We report a complete genomic sequence of rare isolates (minor genotype) of the SARS-CoV from SARS patients in Guangdong, China, where the first few cases emerged. The most striking discovery from the isolate is an extra 29-nucleotide sequence located at the nucleotide positions between 27,863 and 27,864 (referred to the complete sequence of BJ01) within an overlapped region composed of BGI-PUP5 (BGI-postulated uncharacterized protein 5) and BGI-PUP6 upstream of the N (nucleocapsid) protein. The discovery of this minor genotype, GD-Ins29, suggests a significant genetic event and differentiates it from the previously reported genotype, the dominant form among all sequenced SARS-CoV isolates. A 17-nt segment of this extra sequence is identical to a segment of the same size in two human mRNA sequences that may interfere with viral replication and transcription in the cytosol of the infected cells. It provides a new avenue for the exploration of the virus-host interaction in viral evolution, host pathogenesis, and vaccine development.