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Background and purpose:Increasing thyroid cancer (TC) incidence has caused wide public concern. It is typically interpreted as an increase in the true occurrence of TC but may also relfect changing life style or aging of population or increased diagnostic scrutiny. This study describes the temporal trend for incidence of TC and survival rate of patients by summarizing the 41 years TC incidences and follow-up data in Xuhui District, Shanghai.. Methods:Annual TC incidence data of Xuhui District from 1973 to 2013 were provided by Shanghai Cancer Registry System. The calculation of age-standardized incidence rates (ASIR) was based on the population of the year 1973. Temporal trends in TC incidence were analyzed based on the natural spline regression model. Annual percentage change (APC) was estimated by Jointpoint software from US National Cancer Institute, as well as survival rates were estimated using Kaplan-Meier method by Stata software.Results:During the period from 1973 to 2013, papillary cancer was the dominant type with proportion 69.8%. The ASIRs for female TC were 2.51-2.70 times as high as those for male TC. The average age of TC incidence for male was 50.04±14.71 while for female was 48.57±13.65. When aging factors were removed, incidence rate of TC was on the rise since 1981 with the APC of 8.46% (95%CI: 5.9%-11.1%), and on a rapid growth from 2004 to 2013 with the APC of 20.30% (95%CI: 9.8%-31.7%). The study showed that the 5-year TC survival rate was 95.21%, and the 10-year TC survival rate was 89.09%. In addition, survival rate of female was higher than that of male (χ2=15.43,P=0.000 1).Conclusion:The rising trend of TC in Xuhui District is similar to those in Shanghai and some developed countries. Although the mortality rate of TC is low, it has a rapid increase in incidence. Studies on factors associated with TC will help to clarify the epidemiological features about TC and promote more eff-cient prevention and control strategies.
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Objective To investigate efficient examination for early diagnosis of otitis meida woth effusion in pre-school children.Methods 169 cases (338 ears) with otitis media effusion in preschool children in our clinic were analyzed . All the data were analyzed retrospectively .All the pediatric patients complained symptoms related to rhinosinusitis and pediat-ric snoring while they had not been found hearing impairment .All the pediatric patients were diagnosed due to the history , special physical examination and acoustic impedance .And all the patients were divided into 3 groups:group 1 with rhinosi-nusitis, group 2 with pediatric snoring , and group 3 with rhinosinusitis and pediatric snoring .The incidence rates of otitis media with effusion were analyzed among the three groups and control group .Results The incidence rates for group1, group 2, group 3 and contrl group were 55.96%、48.08%、63.24%、11.19%respectively.According toχ2 test, there were signif-icant difference between group 3 and control group ( P0.05).Conclusion Preschool children are high -risk population, which are attacked by otitis media with effusion .The primary factors include rhinosinusitis and pediatric snoring .Detailed history , careful special physi-cal examination and acoustic impedance are most useful for diagnosis .All the parents , kindergareners and physicians should pay attention to early symptoms , otherwise early diagnosis and early treatment will be missed .
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Background and purpose:In 2013, the ofifcial journal of European Society of Radiotherapy &Oncology (ESTRO) -Radiotherapy & Oncology published the updated version of Consensus Guidelines of Delineation of the neck node levels for head and neck tumors, which contributed to the standardization of description of neck nodal metastasis, as well as reduction of treatment variations from various institutions. This study applied this updated guidelines to analyze the patterns of lymph node metastasis of nasopharyngeal carcinoma and explore the prognostic value of the radiologic characteristics of nodes, in order to provide evidence for future revision of N staging system. Methods:A total of 656 patients from Jan. 2009 to Dec. 2010 were retrospectively recruited to analysis. All were pathologically diagnosed as non-metastatic nasopharyngeal carcinoma, treated with intensity-modulated radiotherapy. All patients received a pretreatment MRI scan. We retrospectively reviewed the MRI imaging of 656 patients and mapped the lymph node metastasis using the 2013 International Consensus Guidelines.Results:Median follow-up was 46.9 months. Four-year local recurrence-free survival, nodal recurrence-free survival, distant metastasis-free survival, disease-free survival and overall survival was 91.3%, 95.1%, 87.7%, 78.5% and 92.8%, respectively. The most common metastatic node levels were levelⅡ (76.2%) and levelⅦa (65.1%), followed by levelⅢ (50.4%),Ⅴa(17.5%) andⅣa (11.7%). There was a very low incidence of node skipping (1.0%). Cervical nodal necrosis was observed in 46.4%of patients with positive nodes and extracapsular spread was noted in 74.4% of them. Univariate analysis showed that bilateral nodal involvement, greatest dimension of positive nodes (≥6 cm), central nodal necrosis, T stage and N stage were prognostic factors for disease-free survival and distant metastasis-free survival (P<0.05). Extracapsular spread showed a trend to correlate with poor distant metastasis-free survival (P=0.060). The involvement of lower neck levels (below the caudal border of cricoid cartilage) did not have a signiifcant impact on disease-free survival and distant metastasis-free survival. In multivariate analysis, T stage and greatest dimension of nodes (≥6 cm) were independent prognostic factors for distant metastasis-free survival (P<0.05). T stage, greatest dimension of nodes (≥6 cm) and central nodal necrosis were independent prognostic factors of disease-free survival (P<0.05).Conclusion:This study demonstrates the patterns of lymph node metastasis of nasopharyngeal carcinoma based on 2013 International Consensus Guidelines. Bilateral nodal involvement, greatest dimension of positive nodes and central nodal necrosis had prognostic values on disease-free survival and distant metastasis-free survival. In our study, the involvement of lower neck levels was not proved to be a prognostic factor for disease-free survival and distant metastasis-free survival.
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Background and purpose:Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) can be used for MR imaging systemic examination, especially the lymph node and bone diseases can be clear, and the imaging result is similar with PET. The aim of this study was to compare the value of clinical application in the diagnosis of malignant metastatic osteopathic between DWIBS and bone scintigraphy mapping. Methods:Thirty-six specimens conifrmed with malignant tumors by the pathology of operation or biopsy underwent both DWIBS imaging and bone scintigraphy mapping, chi-square test was used for comparing the detection results of bone metastasis by this two imaging methods. Results:Thirty (165 positions in all) of 36 malignant tumor patients were conifrmed as having bone metastasis, compared that 26 patients (143 positions) with DWIBS method and 23 patients (132 positions) with bone scintigraphy mapping were detected, but there was no statistical signiifcance between this two imaging methods (χ2=1.002, P=0.506). The sensitivity, positive predictive value (PPV) and accuracy of the detection rate of bone metastasis were similar in DWIBS and bone scintigraphy, with 86.7%, 96.3%, 86.1%and 76.7%, 88.5%, 72.2%, respectively;but the speciifcity and negative predictive value (NPV) in DWIBS (83.3%and 55.6%) was higher than that of in bone scintigraphy (50.0%and 30.0%). The detection rates of different bone metastasis with DWIBS and bone scintigraphy were 86.7%(143/165) and 80.0%(132/165), and it was no signiifcant difference (χ2=2.640, P=0.104);DWIBS method was better than bone scintigraphy in the detection of osseous metastasis on pelvis and limbs long bone, and there was different signiifcant (χ2=6.783 and 7.636, P=0.023 and 0.016). Conclusion:DWIBS could detect bone metastatic lesions effectively, and there is ifne consistency with bone scintigraphy. Therefore, DWIBS is to hope to be extended and applicated clinically.
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Objective To evaluate and recognize the dynamic and morphological MRI charactristics of ductal carcinoma in situ (DCIS) of the breast and provide imaging information for the early detection and treatment planning Methods All MRI data in 71 patients with histollogically proved DCIS were analyzed retrospectively. The 71 patients were divided into two groups, NI ( pure DCIS, 44 patients) and N2 ( DCIS with microinvasion, 27 patients). According to the BI-RADS descriptors, all lesions were defined as a focus (smaller than 5 mm in diameter), mass and no-mass-like three enhancement types. The morphological features (M1 = focus, M2 = linear or linear-branched, M3 = branching-ductal, M4 = segmental, M5 = focal,M6 = regional, M7 = diffuse, M8 = mass) and the time-intensity curve (TIC) pattern [type l ( persistent enhancement curves), type Ⅱ( plateau), type Ⅲ(washout) and type Ⅳ (the same enhancement as glandular tissue)] were described. Chi-square test was used for the morphological characteristics of lesions.Results The 73 DCIS lesions were found in 71 patients, and 5.5% (n =4) were stippled lesions, 87.7%( n =64) were no-mass-like lesions, 6.8%(n=5) were mass-like lesions. In no-mass-like lesions (n=64), M3 was found in 15 cases, M4 in 34 cases, M5 in 9 cases and M6 in 6 cases, respectively, M3 and M4 were the most common distribution patterns. In N1 group(n =45) and N2 group (n =28), M3, M4,M5, M6 were found in 7 and 8, 21 and 13, 7 and 2, 3 and 3 cases, respectively. There were no statistic differences between two groups (P＞0.05). In 31 showed heterogeneous enhancement, both M3 and M4 were observed in 35.5% (11/31). In 26 clustered ring enhancement lesions, M4 was observed in 88.5% (23/26). Four lesions showed reticular enhancement,2 lesions showed a clumped enhancement and 1 lesion showed homogeneous enhancement. In 5 mass-like lesions, N1 group had 3 cases, N2 group had 2 cases.Four lesions showed lobulated margin, 4 lesions showed speculated margin, 1 mass showed smooth margin.Five mass showed heterogeneous enhancement. Type Ⅰ , type Ⅱ , type Ⅲ and type Ⅳ TIC ( n = 25) were demonstrated in 8, 11, 3 and 3 lesions, respectively. Conclusions M3, M4, especially segmental clustered ring enhancement, are the most common morphological characteristics of DCIS. Type Ⅰ and type Ⅱ TIC are the most common types.
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dneys, renal hilars and adjacent blood vessels. Conclusions Most of the adrenal lymphoma manifested as large soft tissue masses with shght contrast enhancement. The larger lesions were likely to invade the ipsilateral kidney and adjacent blood vessels.
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OBJECTIVE@#To evaluate the value of super-elective transcatheter external carotid arterial embolization (TAE) in the treatment of intractable epistaxis.@*METHOD@#Forty-six cases of intractable epistaxis were selected, TAE was performed in 36 cases and externa carotid artery ligation was elected in 10 cases.@*RESULT@#The curing rate was 88.9% (32/36) in cases treated by TAE and was 40.0% (4/10) in cased treated by external carotid artery ligation, and the average hospital days of the former was 4.8 days, while the latter was 10 days. Recurrency were effectively stopped bleeding by all kinds of methods, and complications were rare.@*CONCLUSION@#Transcatheter external carotid arterial embolization is a simple, safe and effective treatment for the intractable epistaxis, which has more advantages than external carotid artery ligation, and comprehensive methods can effectively and thoroughly cure intractable epistaxis.
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Adult , Aged , Female , Humans , Male , Middle Aged , Carotid Artery, External , Embolization, Therapeutic , Methods , Epistaxis , Therapeutics , Treatment OutcomeABSTRACT
OBJECTIVE@#To explore the different and common features between adults and children with otitis media with effusion (OME) on course of disease, clinical characteristics and audiometric changes.@*METHOD@#Pure tone audiometry, tympanogram and clinical information were analyzed and compared between 34 cases of adults and 42 cases of children with OME.@*RESULT@#The course of disease was relatively short in children. The adenoid vegetation inflammation was more frequently found in children, while the OME occurred more often in adults. The air conduction and bone conduction threshold increased both in children and adults, particularly at high frequencies of 2 and 4 kHz. The bone conduction threshold at 4 kHz in adults was significantly higher than that in children (P < 0.05). In the cases with C type tympanogram, the negative pressure in adults was even lower than that in children (P < 0.05).@*CONCLUSION@#The OME in children is often relatively shorter in course of disease, which is mainly caused by adenoid vegetation. Sensorineural deafness can occur both in children and adults, especially at high frequencies. OME in children is less severe, however, it may lead to negative effects in learning and cognition, which should be diagnosed and managed in time.
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Young Adult , Acoustic Impedance Tests , Audiometry, Pure-Tone , Bone Conduction , Inflammation , Pathology , Otitis Media with EffusionABSTRACT
OBJECTIVE@#To explore the better management of the stoma in endoscopic dacryocystorhinostomy.@*METHOD@#To review the 102 chronic dacryocystitis patients (109 eyes), who underwent the endoscopic dacryocystorhinostomy surgery with silver clips used to maintain the stoma. They were given combined therapy after the surgery, and were followed up for a period range from 3-73 months.@*RESULT@#99/109 eyes (91%) were cured, 5/109 eyes (4.5%) were improved, and the total effective rate reached to 104/109 (95.5%).@*CONCLUSION@#The application of silver clip in endoscopy dacryocystorhinostomy surgery and combined therapy after the surgery can effectively prevent the stoma stenosis or atresia.
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Dacryocystitis , General Surgery , Dacryocystorhinostomy , Methods , Endoscopy , Treatment OutcomeABSTRACT
To investigate the clinical features of laryngeal papilloma in children.Method:In a group of 62 patients with laryngeal papilloma in children,the tumors of 28 patients were cut under the direct laryngoscope,34 patients were treated with laryngeal micro-laser operation.Result:The post-operation followup ranged from 2 to 5 years,the cure rate of 2 years was 51.61%.Conclusion:The clinical features of this disease include rapid development,a large lesion,and it is often found in the infraglottic cavity.Furthermore,we believe that in order to eliminate the tumors more accurately and decrease recurrence,microlaser surgery and the use of interferon is very necessary.
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Objective To evaluate the tumor targeting characteristic by observing signal varying of human gastric cancer transplanted nude mice (SGC-7901) using Folate-Receptor MR contrast agent. Methods As a Folate-Receptor MR contrast agent, Gd-DTPA-Folate was obtained by conjugation of DTPA-Folate and GdCl3 under specific conditions. Nude mice of subcutaneously transplanted human gastric cancer (SGC-7901) were used as animal models, 12 mice were divided into experimental group(n=6) and control group(n=6) randomly. Both were injected with Gd-DTPA-Folate and Gd-DTPA (contained same gadolinium) via abdominal cavity respectively. Tumor signal varying was observed by T1WI after injection of contrast agent immediately,1,2,3,4,6,12 and 24 h, and tumor signal changing of experimental group was compared with that of control group. CNR (contrast noise ratio) was regarded as evaluating mark. Results Tumor signal intensity of experimental group was increased evidently between 1-2 hours after injecting Gd-DTPA-Folate. Comparison with pre-injection, there was a significant difference(evaluating mark is CNR: q1=5.80, q2=4.64; P0.05). Conclusion Gd-DTPA-Folate shows definite characteristic of tumor targeting effect to nude mice of subcutaneously transplanted human gastric cancer (SGC-7901).