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The technical operation criteria and clinical application guidelines for pediatric nuclear medicine include information related to the preparations,precautions,responsibilities of nuclear personnel,dosage of radiopharmaceutical,history-taking,imaging protocol,as well as indication and safety,focusing primarily on the usual pediatric nuclear medicine examinations.The purpose of the criteria and guidelines is to offer nuclear medicine physicians a framework that could prove practical and helpful in daily clinical practice.
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Purpose The operating skull base meningioma is difficult,and the blood vessel related complications are extremely dangerous.This paper aims to investigate the value of multi-phase CT angiography in preoperative evaluation of skull base meningioma,hoping to improve the operation safety.Materials and Methods The data of a total of 46 patients with pathologically confirmed skull base meningioma in the First Affiliated Hospital of Bengbu Medical College from January 2015 to December 2016 were retrospectively analyzed.Preoperative multi-phase CT angiography was performed on all patients.Post-processing techniques were used to observe the relationship between the supply artery of the tumor,the tumor body and the adjacent vessels,including multi-plane reformation,volume rendering and multi-phase image fusion,the observed results were compared with the intraoperative findings,and the consistency between preoperative angiographic results and intraoperative findings was evaluated.Results Among the CT angiography data of these 46 patients,44 cases could clearly display the supply artery of the tumor,including 15 cases of simple external carotid artery,13 cases of mixed internal and external carotid artery,16 cases of simple internal carotid artery and 2 unclear cases.Compared with the intraoperative findings,the coincident rate was 84.78％,with a favorable consistency (Kappa=0.78).Among the 46 patients,36 cases had no invasion in blood vessels and 10 cases had vascular invasion.The coincident rate between the results of multi-phase CT angiography and intraoperative findings reached 95.65％,and the consistency was favorable (Kappa=0.93);the coincident rate between the results of arterial phase CT angiography and intraoperative findings was 67.39％,and the consistency was ordinary (Kappa=0.45).Conclusion Multi-phase CT angiography can clearly display the feeding artery of skull base meningioma and its relationship with adjacent vessels,and it is of great significance for the preoperative evaluation of surgical risk,the formulation of surgery program and the improvement of surgical safety.
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The technical operation criteria and clinical application guidelines for pediatric nuclear medicine include information related to the preparations,precautions,responsibilities of nuclear personnel,dosage of radiopharmaceutical,history-taking,imaging protocol,as well as indication and safety,focusing primarily on the usual pediatric nuclear medicine examinations.The purpose of the criteria and guidelines is to offer nuclear medicine physicians a framework that could prove practical and helpful in daily clinical practice.
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Objective To investigate the scintigraphic features of neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) and to explore the clinical significance of 99Tcm-EHIDA hepatobiliary scintigraphy.Methods Hepatobiliary scintigraphy with 99Tcm-EHIDA was performed in 28 genetic confirmed NICCD cases (16 males,12 females,1-8 months).Normal dynamics (i.e.,time-activity curve) of the tracer in heart,liver and kidneys was defined as normal hepatic uptake function.Decreased liver uptake of the tracer and/or prolonged heart and kidneys radioactivity retention was defined as impaired hepatic uptake function.Normal or delayed biliary excretion was defined as radioactivity appearing in the bowel within 60 min or after 60 min.Occluded biliary excretion was defined as absent bowel radioactivity within 24 h.The characteristics of hepatobiliary scintigraphy and their relationship with levels of serum total bilirubin (TB),direct bilirubin(DB),ALT,total bile acid (TBA) were retrospectively analyzed.Statistical analysis was performed using Kruskal-Wallis rank sum test.Results Of 28 NICCD patients,20 showed normal uptake while 8 had impaired hepatic uptake.Ten of twenty patients with normal uptake function showed normal biliary excretion and the others showed delayed biliary excretion.Four of eight cases who presented impaired hepatic uptake function were with delayed biliary and the rest displayed biliary excretion occlusion.Compared with the patients with normal hepatic uptake function,patients with impaired hepatic uptake had significantly higher levels of TB and DB (TB:183.6(128.7-280.9) mmol/L vs 105.5(80.0-141.7) mmol/L,Z=-2.25;DB:135.6 (95.7-212.6) mmol/L vs 73.1(53.9-97.9) mmol/L,Z=-2.73; both P＜0.05).Compared with the cases with normal biliary excretion function,patients with delayed biliary excretion had significantly higher levels of TB,DB and TBA (TB:137.5 (122.0-170.9) mmol/L vs 81.7(65.7-93.5) mmol/L,Z=-3.92;DB:96.5 (81.1-108.0) mrrol/L vs 54.1(45.3-72.6) mmol/L,Z=-3.74; TBA:245.6(183.9-299.2) mmol/L vs 136.0(73.5-163.2) mmol/L,Z=-2.57; all P＜0.05).The levels of TB (262.0(152.1-542.8) mmol/L) and DB (192.7(118.1-407.2) mmol/L; both Z=-2.82; both P＜0.05) were the highest in patients with occluded biliary excretion.Compared with the patients with delayed excretion,the occluded excretion subgroup had significantly higher levels of ALT (71.5 (48.5-144.8) U/L vs 20.0(16.5-27.7) U/L,Z=-2.66,P＜0.05).Conclusion 99Tcm-EHIDA hepatobiliary scintigraphy may evaluate hepatic uptake and excretion function of the NICCD infants.When the hepatic uptake is remarkably decreased,the occluded biliary excretion can be shown.
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BACKGROUND: Sjogre's syndrome is a common disease of aged people,in which, dry mouth and throat have disturbed chawing, swallowing and speech and have seriously affected living quality of patients. OBJECTIVE: To probe into the improvement of oral function treated with Chinese medicine based on differentiation of symptoms. DESIGN: Retrospective analysis on cases was designed. SETTING: Department of Periodontal Disease, College of Stomatology,Fourth Military Medical University of Chinese PLA. PARTICIPANTS: Thirty-six cases of Sjogre's syndrome were selected from clinic of Department of Periodontal Disease of Stomatology College of Fourth Military Medical University of Chinese PLA from May 2000 to February 2004, with agreement and in the know of patients. Of those, 5cases were male, 31 cases were female, aged varied from 27 to 70 years,with duration of sickness in range from 0.5 to 10 years. METHODS: ① On basis of moistening, drying up heat, producing fluid and stopping thirst, the drugs for activating blood circulation, resolving stasis, clearing away heat and detoxification were supplemented. Formula:shashen (Radix Glehniae), maidong (Radix Ophiopogonis), shihu (Herba Dendrobii), yuzhu (Rhizoma Polygonati Odorati), huafen (Radix Trichosanthis), xuanshen (Radix Scrophulariae), shengdi (Radix Rehmanniae), chenpi (Pericarpium Cirri Reticulatae), danshen (Radix Salviae Miltiorrhizae), banzhilian (herba Scutellariae Barbatae), bahuasheshecao (Herba Hedyotis Dissusae), etc. ②Treatment of vitamins and transfer factor were associated.③ Artificial saliva in local was applied to prevent from secondary infection. ④ It was to test 99Tc m parotid function (After 99Tc m was injected intravenously on elbow, the parotid uptaking and concentrated 99Tc m curve were traced immediately. When radioactivity intensity was increased to maximum, the patients were required to chaw Vit. C tablet, 200 mg. In following, it was to trace the minimum of 99Tc m radioactivity on decreased curve. Normal imaging was illustrated clearly, the development after Vit. C stimulationwas declined swiftly. Time-radioactivity curve illustrated obvious uptaking and excreting segments. Positive results were unclear parotid development or the development after Vit. C stimulation was not declined obviously. Time-radioactivity curve was of horizontal type, low-horizontal type, parabola type or persistent rising type), erythrocyte sedimentation (ERS) (Normal value: 0-15 mm/h for male adult, 0-20 mm/h for female adult) and a part of immunology, such as rheumatoid factor, immunoglobulin (I gG normal value: 7.6-16.6 g/L), immune complex, etc. The effect was determined as increased saliva secretion and improved oral function. MAIN OUTCOME MEASURES: 99Tc m parotid function test, rheumatoid factor, ERS, IgG and immune complex were applied to determine the therapeutic effects of Chinese herbs. RESULTS:Thirty-six cases all entered result analysis. ① After treatment, the positive rate of rheumatoid factor was lower significantly compared with that before treatment [36.7％, 73.3％,(x2=6.796, P ＜ 0.01)]. The levels of ERS, IgG and immune complex were all decreased significantly compared with those before treatment [(35.50±5.65) mm/h,(13.47±1.58) g/L,(8.30±1.24) mg/L;(55.20±8.85)mm/h,(23.57±2.37) g/L,(14.96±2.21) mg/L; (t=3.549-4.962,P ＜ 0.01)]. The result of 99Tc m parotid function test and main determined indexes had been improved for all. ② After treatment, dry mouth, dry eye and general symptoms were all improved of various degrees and saliva secretion was increased. Total effective rate reached 80.7％. CONCLUSION: Treatment based on differentiation of symptoms is applied in Chinese medicine. On basis of moistening, drying up heat, producing fluid and stopping thirst, the drugs for activating blood circulation, resolving stasis, clearing away heat and detoxification are supplemented and effectively promote rehabilitation of oral function in Sjogre's syndrome,such as chawing, swallowing, speech, etc.
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Objective:To study the clinical effect of corticosteroids (C S) with small dosage in the recurrence control of pemphigus. Methods: 25 cases of pemphigus were diagnosed by clinical and pathological examinati on.They were treated with CS at 60-80 mg/d in acute stage for symptom control.Th en,the dosage of CS was decreased by 5 mg in each following 2 weeks untill it re ached 2.5 mg/2 d. The treatment of 2.5 mg/2 d was continued for 1 year and was a ssisted with tripterygium polyglycoside, compound thalidomide, compound cyclopho sphamide (compounded with total saponins of ginseng), dapsone, and/or some kidne y-supplementing herbs. The patients were followed-up for 9~16 years.Re sults:No recurrence was observed in 16 cases(64%).Recurrence was found i n 9 cases(36%),among them 7(28%) were with light symptom and 2(8%) severe. Sever e side-effect was not found in all cases. Conclusion:The recurr ence of pemphigus may be controlled without severe side-effect by long-term us e of small dosage of CS assisted with proper immuno-inhibitors, immuno-regulat ors and/or some kidney-supplementing herbs.
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Objective:To analyse the clinical characteristics and to study the effects of thalidomide combined with tripterygium glycosides in the treatment of Behcet disease.Methods:50 cases of Behcet disease were analysed retrospectively.26 of them were treated by thalidomide at 35 mg combined with tripterygium glycosides at 10 mg 3 times a day.24 cases were treated by levamisole at 50 mg 3 times a day with 3-day-treatment and 11-day-interval.All the patients were treated for 2 months.Results:Middle-aged male patients with chronic onset were common,oral ulcer was the first common symptom.The disease could damage all organs,however the oral mucosa,skin,oculus,genitalia and joint were commonly involved.Reaction of needle puncture was highly specific in the diagnosis.The effective ratio of treatment was observed in 92% of the patients treated by the combination of thalidomide with tripterygium glycosides and in 67% of those by levamisole.Conclusion:The clinical manifestations of Behcet disease are complex,its diagnosis mainly depends on symptoms and signs,reaction of needle puncture is helpful in diagnosis.Thalidomide combined with tripterygium glycosides is effective in the treatment of the disease.