ABSTRACT
Objective To compare the value of monoexponential and biexponential models in the preoperative evaluation of myometrial invasion in endometrial carcinoma.Methods 35 cases of endometrial carcinoma were examined by diffusion weighted imaging (DWI) with monoexponential model (b=0,800 s/mm2)and biexponential model (b=0,50,100,150,200,400,600,800,1 000,1 200,and 1 500 s/mm2),including 14 cases of deep myometrial invasion and 21 cases of non-deep myometrial invasion.The values of apparent diffusion coefficient (ADC),pure diffusion coefficient,perfusion related diffusion coefficient and the microvascular volume fraction were measured by the Matlab software.These parameters of two groups were compared and analyzed,respectively.Results The D value and the ADC value in the deep myometrial invasion group of endometrial carcinoma were lower than those in the non-deep myometrial invasion group,and the differences were statistically significant (both P<0.001).There was no significant difference between the two groups in the f value(P=0.600)and D?value(P=0.600).The AUC of ADC value and D value for the differential diagnosis of endometrial carcinoma with and without deep myometrial invasion were 0.9 1 3 and 0.9 6 9,respectively.Based on the Youden index and its corresponding optimal cut-point,the sensitivity of ADC value and D value were 90.48% and 100%,respectively,and the specificity of ADC value and D value were both 85.71% in differential diagnosis of endometrial carcinoma with and without deep myometrial invasion. Conclusion The ADC value in monoexponential model and the D value in biexponential model can be both used to evaluate deep myometrial invasion of endometrial carcinoma,among which D value is better.
ABSTRACT
OBJECTIVE:To observe clinical efficacy and safety of Xuebijing injection combined with octreotide and ulinastatin in the treatment of acute severe pancreatitis.METHODS:A total of 150 patients with acute severe pancreatitis admitted to emergency department of our hospital during Jan.2012-Jan.2016 were divided into control group,drug control group and observation group according to therapy method,with 50 cases in each group.All patients were treated with fasting,gastrointestinal decompression time,antibiotics,blood purification and other conventional treatment.Control group additionally received Cctreotide acetate injection 0.1 mg intravenously,tid,on the basis of conventional treatment.Drug control group additionally received Ulinastatin for injection 100 000 U added into 10％ Glucose injection 250 mL,ivgtt,bid,on the basis of control group.Observation group additionally received Xuebijing injection 100 mL added into 10％ Glucose injection 100 mL,ivgtt,bid,on the basis of drug control group.Three groups were treated for 10 days.The clinical indexes as fotal response rates,gastrointestinal decompression time,abdominal pain relief time,length of stay were observed in 3 groups.Related serum indexes (AMY,WBC,IL-6,CRP,TNF-α) before and after treatment and the occurrence of compliance during treatment were compared among 3 groups.RESULTS:The total response rate of observation group was 90.0％,which was significantly higher than 72.0％ of drug control group and 52.0％ of control group,with statistical significance (P＜0.05).The gastrointestinal decompression time,abdominal pain relief time and length of stay in observation group were significantly shorter than drug control group and control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in the serum levels of AMY,WBC,IL-6,CRP or TNF-α among 3 groups (P＞0.05).After treatment,above serum indexes of 3 groups were decreased significantly,and observation group was significantly lower than the drug control group and control group,with statistical significance (P＜0.05).The incidence of ARDS,shock and acute renal failure in observation group were significantly lower than drug control group and control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of sepsis,abdominal abscess or MODS among 3 groups (P＞0.05).CONCLUSIONS:Xuebijing injection combined with octreotide and ulinastatin show significant therapeutic efficacy for acute severe pancreatitis,can effectively control inflammation progress,improve clinical symptoms and promote disease recovery with good safety.