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Purpose To investigate the multi-slice spiral CT (MSCT) features ofchromophobe renal cell carcinoma (CCRC),renal oncocytoma (RO) and clear-cell renal cell carcinoma (CCRCC) for the improvement of its diagnostic accuracy.Materials and Methods The MSCT data of 15 CCRC cases,8 RO cases,and 29 CCRCC cases confirmed by surgery or pathology at Dong H ua Hospital from October 2012 to April 2016 were retrospectively studied.The CT signs of different tumors were compared.Results Most CCRCC cases had cystic degenerations,which showed significant difference with CCRC and RO cases (P＜0.05);RO cases were found mostly with star-shaped scars,which had significant difference with CCRCC cases (P＜0.05);the enhanced scanning showed most of CCRC were enhanced homogeneously,which presented significant difference from CCRCC (P＜0.05).The lesion-kidney-ration (LKR) of CCRCC at cortical phase,parenchymal phase or excretory phase was significantly different from that of CCRC (P＜0.05);the LKR of CCRCC at cortical phase was significantly different from that of RO (P＜0.05);the LKR of CCRC at the three phases were all significantly different from that of RO (P＜0.05).The average △ LKR value of CCRCC was significantly different from that of CCRC and RO (P＜0.05);there was a certain degree of difference distribution of their △ LKR among the three kinds of cases.Taking CCRCC as object,when the LKR at cortical phase was 0.693 or △ LKR was 0.068,the sensitivity reached 93.3％ and the specificity reached 72.2％ or 88.9％ respectively in evaluating the differential diagnosis of CCRC and RO.Taking RO as object,when the LKR was 0.656 at cortical phase or was 0.595 at parenchymal phase,the sensitivity reached 83.3％ and 91.7％ respectively,and the specificity was 75.0％ and 58.3％ respectively,in evaluating the differential diagnosis of CCRC.Conclusion Enhanced MSCT at different phases,especially the calculation of LKR and △ LKR value,can benefit the diagnosis of CCRC,RO and CCRCC.
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Objective To observe the clinical effects of ornithine aspartate (OA) and lactulose on the prevention and treatment of hepatic encephalopathy for patients with portal hypertension after modified transjugular intrahepatic portosystemic shunt (TIPS).Methods Fifty-six patients with portal hypertension were treated by modified TIPS,OA and lactulose after the operation were given,the incidence of postoperative hepatic encephalopathy and the changes of blood ammonia were observed.Patients with hepatic encephalopathy after modified TIPS accepted therapeutic dosage of OA and lactulose,and the clinical effects of combined OA and lactulose on treatment of the hepatic encephalopathy after modified TIPS and changs of blood ammonia were evaluated as well.Results Prophylactic use of combined OA and lactulose after modified TIPS,there was no hepatic encephalopathy happened in 56 patients.Hepatic encephalopathy was seen in 5 patients after discontinuation of combined OA and lactulose,the incidence rate of hepatic encephalopathy was 8.93％ (5/56).The level of blood ammonia in patients after modified TIPS was significanby higher than that before treatment [(88.2 ± 23.0) μ mol/L vs.(43.1 ± 19.2) μ mol/L,P ＜ 0.05].Five patients with hepatic encephalopathy was improved quickly after given therapeutic dosage of OA and lactulose (the average treatment time was 7 d),and the level of blood ammonia was significantly lower than before treatment [(69.1 ± 14.1) p mol/L vs.(139.2 ± 15.8) μ mol/L,P＜ 0.05].Conclusion Combined OA and lactulose can effectively prevent and treat the hepatic encephalopathy after modified TIPS,its mechanism may be associated with reduction of blood ammonia level.
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Purpose:To understand the effect of ligustrazine on preventing the thrombosis "after percutaneous transluminal angioplasty(PTA).Materials and Methods:Dogs models(n=10)with exper- imental renal arterial stenosis were selected and randomly divided into control and experimental groups with 5 dogs for each. Experimental group dogs were injected ligustrazine(40mg/kg)15 days before PTRA.Peripheral blood samples were collected before recelived drug,before and 4 hours after PTRA in the experiment group;before and 4 hours after PTRA in the control group.Plasma concentrations of thromboxane B2_(TXB_2)and 6-keto-PGIl? were determined by radioimmunoassay.Rates of platelet ag- gregation were also determined by ADP-induced.All dogs were killed 4 hours after PTRA.Renal arteries were removed before killing.The thrombus volume at PTRA sites were measured.Results:Liguslrazine might significantly inhibit platelet aggregation,decrease TXA_2 produced by platelet and increase PGI_2 synthesized in the blood vessel.Therefore,ligustrazine might significantly inhibit thrombosis at the PTRA sites.It Suggests that Ligustrazine could be an effective drug for preventing restenosis of thromboses after PTA.