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Objective:To investigate the clinical effect and safety of camrelizumab combined with induction chemotherapy followed by concurrent chemoradiotherapy for patients with locally advanced nasopharyngeal carcinoma (NPC).Methods:A total of 24 patients with stage Ⅲ-IV A NPC were recruited prospectively to receive two cycles of camrelizumab combined with induction chemotherapy (docetaxel 75 mg/m 2+ cisplatin 25 mg/m 2 for three consecutive days) followed by concurrent chemoradiotherapy (prescription doses: 6 996 cGy in 33 fractions for PGTV and PGTV nd, 6 006 cGy in 33 fractions for PTV 1, 5 096 cGy in 28 fractions for PTV 2, and concurrent cisplatin chemotherapy with a dose of 75 mg/m 2). The short-term efficacy and adverse reactions were evaluated. Results:After induction therapy, nasopharyngeal lesions showed an objective response rate (ORR) of 91.6%, including 45.8% of complete response (CR) and 45.8% of partial response (PR); cervical lymph nodes showed an ORR of 95.8% (CR: 4.2%; PR: 91.6%). Seventeen patients accepted a reexamination under a nasopharyngoscope, and the biting biopsy result indicated that 13 patients among them had complete pathologic response. After concurrent chemoradiotherapy, nasopharyngeal lesions and cervical lymph nodes showed CR rates of 83.3% and 91.7% and PR rates of 16.7% and 8.3%, respectively. After the induction therapy, 13 patients with stage IV A NPC had ORR (PR) rates of 92.4% and 92.4%, respectively, at nasopharyngeal lesions and cervical lymph nodes. After concurrent chemoradiotherapy, the patients with stage IV A NPC had CR rates of 84.6% and 92.3% and PR rates of 15.4% and 7.7%, respectively, at nasopharyngeal lesions and cervical lymph nodes. Major adverse reactions include leukopenia, granulopenia, anemia, radioactive acute oropharyngeal mucositis and dermatitis, digestive tract reaction, fatigue, hypothyroidism, aminotransferase elevation, and reactive capillary hyperplasia. Conclusions:Camrelizumab combined with induction chemotherapy followed by concurrent chemoradiotherapy can achieve high short-term efficacy for patients with locally advanced nasopharyngeal carcinoma, without increasing the incidence of adverse reactions. Its long-term efficacy deserves further research.
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Objective:To screen the serum exosomal microRNAs differentially expressed in early pancreatic cancer patients and evaluate the diagnostic value of exosomal hsa-let-7f-5p.Methods:From January 2019 to January 2020, 19 patients with early pancreatic cancer (early pancreatic cancer group) and 16 patients with chronic mass-forming pancreatitis (pancreatitis group) were selected from Affiliated Hospital of Nanjing University of Chinese Medicine who underwent surgery and were confirmed by pathology. Serum samples of the two groups of patients were collected. At the same time, serum samples of 19 healthy volunteers were selected as the normal control group. The exoEasy Maxi Kit was used to isolate serum exosomes. The structural characteristics of exosomes were observed by transmission electron microscopy (TEM). The particle size of exosomes was observd by nanoparticle tracking analysis. CD 63 and CD 81, the specific protein marker on the surface of exosomes, were identified by western blotting. The total RNA of exosomes was extracted by the miRNeasy Serum/Plasma Kit, and a small RNA library was constructed after quality inspection. With reference to the small RNA database, the differentially expressed exosomal microRNAs in early pancreatic cancer group, pancreatitis group and normal control group were filtered out. The miRNA candidates were validated by quantitative polymerase chain reaction (qPCR) and different expressions of them were analyzed. The role of target genes and metabolic pathways of candidate miRNAs in the occurrence and development of early pancreatic cancer were analyzed by gene ontology (GO) and Kyoto Encyclopeda of Genes and Genomes(KEGG) enrichment pathway. Results:The isolated serum exosomes can be seen to have cup-like vesicle with the double lipid layer by TEM. The main peak of the particle size of target exosomes was about 150 nm. The expression of exosome specific protein markers CD 63 and CD 81 was positive. Comparing the expression of miRNAs among early pancreatic cancer group, pancreatitis group and normal control group, the specific tumor marker exosomal hsa-let-7f-5p was screened out in this study, and its expression in early pancreatic cancer group was significantly higher than that in pancreatitis group and normal control group (both P values <0.05). Receiver operating characteristic curve analysis (ROC) showed that the area under curve (AUC) of exosomal hsa-let-7f-5p to distinguish pancreatic cancer from pancreatitis was 0.843 (95% CI 0.640-1.000). The sensitivity and specificity were 100% and 81.82% respectively. The AUC for distinguishing pancreatic cancer from normal controls was 1.000 (95% CI 1.000-1.000), and both sensitivity and specificity were 100%. The diagnostic efficiency of exosomal hsa-let-7f-5p was equivalent to that of CA19-9 ( P>0.05). The GO analysis results showed that target genes of exosomal hsa-let-7f-5p were mainly involved in complement activation lectin pathway in biological processes, and the proteins expressed by target genes were mainly distributed in cilium, and molecules mostly functioned by combining with nitric-oxide synthase. The KEGG pathway enrichment analysis showed that the target genes were closely related to MAPK signaling pathway. Conclusions:Serum exosomal hsa-let-7f-5p has the potential to be a diagnostic biomarker for early pancreatic cancer.
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Objective:To explore the application value of clinical case-based learning in medical imaging teaching.Methods:A total of 145 clinical medical students from three classes in the third year were enrolled and they were divided into three classes. One class took case-based learning, one class took traditional teaching, and one class took both. The teaching content was the preclinical medical professional course—Medical Imaging. Continuous variables were expressed in accordance with normal distribution (mean standard deviation). Differences in mean and median values were evaluated by using t test and the Mann-Whitney U test, respectively. Categorical data were compared using the chi-square test. Results:There was a significant difference between the combined teaching class and the case-based learning class or the traditional teaching class in the final exam ( P=0.002). There was also a significant difference between the combined teaching class and the traditional teaching class in the film reading quiz ( P=0.035). More than 70% of students recognized the case-based learning. Conclusion:Case-based learning is helpful to improve students' flexible application of relevant knowledge and skills of analysis and communication.
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To explore the value of magnetic resonance diffusion-weighted imaging (MR-DWI) for evaluating inflammatory activity of perianal Crohn's fistula. Methods: A total of 55 patients, who were diagnosed as perianal Crohn's fistula by surgery and/or endoscopy, were assessed retrospectively. All patients, underwent pelvic magnetic resonance imaging (MRI) before and 32 weeks after the treatment, were divided into 2 groups according to their response to treatment: an effective group (34 cases) and an ineffective group (21 cases). The MRI images of patients in the 2 groups were analyzed. The changes of apparent diffusion coefficient (ADC) values before and after treatment in the 2 groups were measured and compared by a paired t-test. An MRI-based score of perianal Crohn's disease severity was calculated as a reference standard, and the correlation between the ADC value and the MRI-based score was analyzed by using a Pearson correlation coefficient method. Results: In the effective group, the ADC values after therapy were significantly greater than those before therapy (P0.05). There was a strong negative correlation between the ADC values (after and before therapy) and the MRI-based scores in all the patients [in the effective group alone (r=-0.672, P<0.01) or in the effective group + the ineffective group (r=-0.638, P<0.01)]. Conclusion: Changes in the ADC values of perianal fistula are related to the fistula activity. MR-DWI and ADC value can accurately evaluate the inflammatory activity of perianal Crohn's fistula.
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Humans , Crohn Disease , Diffusion Magnetic Resonance Imaging , Fistula , Retrospective StudiesABSTRACT
Objective To evaluate the efficacy and safety of stereotactic body radiation therapy (SBRT) using Cyberknife in the treatment of patients with recurrent cholangiocellular carcinoma (RCC) after surgery.Methods Clinical data of 26 patients with recurrent RCC after surgery undergoing Cyberknife SBRT from 2010 to 2015 were retrospectively analyzed.The median recurrence time was 10 months (range 2.0-63.0 months) and the median tumor diameter was 2.8 cm (range 1.2-4.8 cm).The median prescription dose/fraction was 45 Gy/5f (range 40-50 Gy/3-8 f).The tumor progression was evaluated based on enhanced CT or MRI.Overall survival (OS),progression-free survival (PFS) and local control rate (LC) were analyzed by Kaplan-Meier method.Toxicity was assessed using the common terminology criteria for adverse events version 4.0.Results For the entire cohort,the median OS and PFS were 13.5 months and 6.5 months at a median follow-up of 29.3 months (range 2.1-62.0 months).The 1-and 2-year OS and PFS rates were 52％ and 21％ as well as 28％ and 15％,respectively.Among them,4 patients (4/26,15％) were recurrent in situ after SBRT.Three patients experienced grade Ⅲ adverse reactions including 1 case of gastrointestinal reaction,1 case of liver dysfunction and 1 case of biliary tract infection.Only 1 patient suffered from ≥ grade Ⅳ gastrointestinal bleeding during the advanced stage.Conclusions SBRT using Cyberknife is a safe and effective treatment for patients with recurrent RCC after surgery.The adverse reactions can be tolerated by patients.
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Objective To evaluate the role of 3.0 Tesla magnetic resonance hysterosalpingography (MR?HSG) work?up in the diagnosis of female infertility. Methods Between July 2015 and December 2018, a total of 1 052 infertile women aged from 20 to 40 years in the Affiliated Hospital of Nanjing University of Chinese Medicine were prospectively enrolled in the study. All the patients underwent pelvic plain scanning and X?ray hysterosalpingography (HSG) followed by MR?HSG examination, and the patency of the fallopian tubes as well as the abnormalities of the uterus and ovaries were evaluated. Among which 33 cases were randomly selected. The chi?square test and Kappa test were used to compare the difference and the consistency of the two methods in the evaluation of fallopian tubes. Results MR?HSG and HSG had good consistency in evaluating tubal patency (Kappa=0.88, P<0.01), and there was no statistically significant difference between the two groups (P=0.65). The examination of MR?HSG was successfully completed in 97.1%(1 021/1 052) cases. There were 81.7% (834/1 021) cases had at least one abnormality. Bilateral tubal, uterine and ovarian abnormalitiesoccurred in 42.6% (435/1 021), 34.2% (349/1 021)and 46.8% (478/1 021) cases, respectively. In which tubal abnormalities display the results as follows: bilateral obstructed 4.7% (48/1 021), bilateral poor pass 8.5% (87/1 021), one smooth one obstructed11.7% (119/1 021), one smooth one poor pass 12.6% (129/1 021), and one poor pass one obstructed 5.1% (52/1 021). Conclusion 3.0 T MR?HSG is expected to be a routineexam for evaluating female infertility, which allows a comprehensive assessment of tubal patency and other pelvic abnormalities of infertile women.
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Objective To investigate the diagnostic value of contrast-enhanced CT and MR diffusion-weighted imaging (DWI) in differentiating autoimmune pancreatitis (AIP) from pancreatic carcinoma (PC).Methods Twelve patients with AIP (AIP groups) and 15 patients with PC (PC groups) were included in this study.Contrast-enhanced CT and DWI were performed in all patients.The manifestations of the pancreatic lesions,pancreatic duct and bile duct were observed.The CT attenuation values and the apparent diffusion coefficient (ADC) values of the lesions were calculated.Frequencies of the CT manifestations,and the mean CT attenuation values,and the ADC values were compared between the two groups.Results Most of the AIP showed diffuse enlargement,sausage shape,peripancreatic capsule,penetrating sign of pancreatic duct and thickness of the bile duct.The frequencies of the findings mentioned above were significantly different between AIP and PC (P＜0.05).The CT attenuation values of the lesions,and the rate of lesions' CT attenuation values to livers' in 3 phases of contrast enhanced CT were significantly different between AIP and PC (P＜0.05).The ADC values of AIP were significantly lower than that of PC (P＜0.05).Conclusion The changes of morphology of pancreas,pancreatic and bile duct may facilitate in differentiating AIP from PC.Quantitative analysis of CT attenuation values and ADC values measured on MR images may be helpful in differentiating AIP from PC.
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Objective To investigate the distribution of host animals and the serological distribution and virulence gene of Yersinia eterocolitica in Gaomi City.Methods Sample stools of poultry and domestic and diarrhea patients,as well as flies and chilled (frozen) poultry and domestic animal meats in Gaomi City were preliminarily identified and the suspected strains isolated were sent to Shandong Provincial Center for Disease Control and Prevention for further identification from 2012 to 2015.The bacteria were analyzed by the systematic biochemistry to determine the serotypes,bio-types and virulence genes [Yersinia enterocolitica adhesion aggression site gene (ail),heat-tolerance enterotoxin gene (ystA),organism type 1A enterotoxin gene (ystB),adhesin (yadA),yop regulator transcription activation action factor (virF)].Results Eighty-five stains of Yersinia enterocolitica were detected in 2 860 specimens and the detection rate was 3.0％ (85/2 860).The chicken strains accounted for 50.6％ (43/85),the swine strains accounted for 20.0％ (17/85),and the sheep strains accounted for 10.6％ (9/85).In all the serotypes,the highest was O ∶ 8 (24.7％,21/85),followed by O ∶ 5 (12.9％,11/85),the bacteria were detected in the stools of chickens,duck,and swine etc.,as well as in diarrhea patients and chilled (frozen) poultry and domestic animal meats,biotype is 1A.One strain O ∶ 3/4 was detected from swine stool with ail,ystA,yadA and virF genes.Conclusions The Yersinia enterocolitica is widely distributed and both pathogenic and non-pathogenic strains coexist in Gaomi City;the main serological types are O ∶ 5/1A and O ∶ 8/1A;the pathogenic serotype is O ∶ 3/4,and chicken,swine and sheep are the main host animals.
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Objective To explore the clinical characteristics of and surgical strategies for distal tibiofibular syndesmosis separation based on ankle axial CT scan.Methods From January 2009 to January 2016,63 patients with injury to the distal tibiofibular syndesmosis were treated.Their injuries were characterized according to the anatomic characteristics on their ankle axial CT scan images as pronation-extorsion type (28 cases),supination-extorsion type (11 cases) and abduction type (24 cases).Specific strategies of reduction and fixation depended on the specific characteristics of distal tibiofibular syndesmosis separation.After 12 months postoperatively,the reduction quality was assessed by Burwell-Charnley's radiological evaluation system and the function of ankle joint was assessed using American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score system.Results The patients were followed up for 6 to 48 months (average,19.3 months).Anatomical reduction was achieved in 19 cases,good reduction in 7 and fair reduction in 2 in the pronation-extorsion type,yielding an excellent to good rate of 92.8％;anatomical reduction was achieved in 6 cases,good reduction in 4 and fair reduction in one in the supination-extorsion type,yielding an excellent to good rate of 90.9％;anatomical reduction was achieved in 17 cases,good reduction in 6 and fair reduction in one in the abduction type,yielding an excellent to good rate of 95.8％.By the AOFAS system,the pronation-extorsion type scored 88.6 points,the supination-extorsion type 89.4 points and the abduction type 86.6 points.Conclusion In the treatment of distal tibiofibular syndesmosis separation,reduction and fixation strategies should depend on analysis of the characteristics on the ankle axial CT scan,so as to achieve positive outcomes.
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Diabetes mellitus ( DM) is widely considered to be associated with pancreatic cancer ( PC) .Some studies have shown that DM has been recognized as a risk factor for PC and the early clinical manifestation of PC , however the exact relationship re-mains unclear .The conventional imaging techniques and molecular imaging techniques can evaluate the abnormal condition during the occurrence and development of PC and diabetes .This article will review the correlation between PC and DM and the potential molecular mechanism, such as hyperglycemia, insulin-like growth factors, oxidative stress, islet amyloid polypeptide and Kruppel sample factorⅡgene mutations, etc.In addition, the value of imaging diagnosis for PC and DM is also reviewed .
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<p><b>BACKGROUND</b>There are relatively few reports focusing on clinical and multi-slice CT (MSCT) imaging findings of mucinous tubular and spindle cell carcinoma (MTSCC). Our study aimed to characterize the clinical and MSCT imaging features of MTSCC.</p><p><b>METHODS</b>The imaging findings in 17 patients with MTSCC by MSCT were retrospectively studied. MSCT was undertaken to investigate tumor location, size, density, cystic or solid appearance, calcification, capsule sign, enhancement pattern, and retroperitoneal lymph node metastasis.</p><p><b>RESULTS</b>Tumors (mean diameter, (3.9 ± 1.7) cm) were solitary (17/17), solid (16/17) with cystic components (5/17), had no calcifications (14/17), had a poorly defined margin (14/17), were centered in the medulla (15/17), compressed the renal pelvis (7/17), and neither lymph node nor distant metastasis was found. The attenuation of MTSCC tumors was equal to that of the renal cortex or medulla on unenhanced CT (32.3 ± 2.6, 36.3 ± 4.6, 33.2 ± 3.9, respectively, P > 0.05), while tumor enhancement after administration of a contrast agent was lower than that of normal renal cortex and medulla during all phases (P < 0.05).</p><p><b>CONCLUSION</b>MTSCC tends to be a solitary, isodense mass with poorly defined margin arising from the renal medulla with enhancement less than the cortex and medulla during all phases.</p>
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Adult , Female , Humans , Male , Middle Aged , Adenocarcinoma, Mucinous , Diagnosis , Diagnostic Imaging , Carcinoma , Diagnosis , Diagnostic Imaging , Carcinoma, Renal Cell , Diagnosis , Diagnostic Imaging , Kidney Neoplasms , Diagnosis , Diagnostic Imaging , RadiographyABSTRACT
Objective To investigate the differential diagnostic features of subtpes of renal cell carcinoma (RCC) using CT scan.Methods The CT appearances of 53 RCCs,including 28 clear cell RCCs (CCRCC),6 Xp11.2 /TFE RCCs (Xp11.2 /TFE RCC),7 collecting ducts RCCs (CDC),12 chromophobe RCCs (CRCC),were retrospectively analyzed and compared with finding of pathology.Dynamic contrast-enhanced CT (DCE-CT) was conducted in each case after intravenous administration of contrast agent,and the data was analyzed by AVONA and LSD text.Results On unenhanced and enhanced CT,most CCRCCs and CDCs showed heterogeneous density (23/28,6/7),with necrosis (21/28,6/7),and most Xp11.2/TFE RCCs,CRCCs showed homogeneous density(5/6,8/12).Most CCRCCs,Xp11.2/TFE RCCs and CRCCs had clearly boundaries with well demonstrated at enhanced CT delayed phase (25/28,6/6,10/12),CDCs had unclearly boundaries (6/7),and most CCRCCs had lymph node or other metastasis (19/28).A phenomenon of quick staining and quick fainting was observed in CCRCCs.Xp11.2/TFE RCCs,CDCs,CRCCs showed delayed enhancement.On unenhanced CT,the Xp11.2/TFE RCC attenuation was greater than CCRCC,CDC,CRCC and normal renal cortex (53.7±4.1 vs 45.8±3.6 vs 41.4±2.4 vs 47.7±3.6 vs 41.5±5.1,F=5.458,P＜0.01,respectively).The enhancement degree was highest for CCRCCs,lowest for CDCs,and intermediate for Xp1 1.2/TFE RCCs and CRCCs.The enhancement degree of Xp1 1.2/TFE RCC was higher than that of the CDC and CRCC (P＜ 0.01).The enhancement degree of Xp11.2/TFE RCC and CRCC were higher than that of the normal renal medulla at cortical and medullary phases (P＜0.01),but lower than that of the renal medulla on delayed phase (P＜0.01).The enhancement degree of CDC were lower than that of the normal renal cortex and medulla on cortical,medullary and delayed phases (P＜0.05).Conclusions CT could distinctly show imaging features of CCRCC,Xp1 1.2/TFE RCC,CDC and CRCC,which were related to their pathological characteristics,and these features were helpful in predicting a specific subtype of RCC.
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<p><b>OBJECTIVE</b>To investigate the changes in fecal flora and its correlation with the occurrence and progression of inflammatory bowel disease (IBD).</p><p><b>METHODS</b>We collected fresh fecal specimens from 167 IBD patients (including 113 with ulcerative colitis and 54 with Crohn's disease) and 54 healthy volunteers. The fecal flora was analyzed by gradient dilution method and the data of inflammatory markers including WBC, PLT, CRP and ESR were collected to assess the association between the fecal flora and the inflammatory markers.</p><p><b>RESULTS</b>The species Enterrococcus (6.60∓0.23, P<0.01), Saccharomyces (2.22∓0.27, P<0.05), Bacteriodes (5.57∓0.28, P<0.001), Bifidobacterium (5.08∓0.30, P<0.01), Peptococcus (6.22∓0.25, P<0.001), Lactobacillus (6.00∓0.26, P<0.001), and Clostridium (3.57∓0.30, P<0.05) all increased significantly, while Eubacterium (1.56∓0.24, P<0.01) reduced markedly in patients with ulcerative colitis compared with those in the control subjects. Enterrococcus (6.93∓0.28, P<0.01), Saccharomyces (2.73∓0.37, P<0.01), Bacteriodes (4.32∓0.52, P<0.05), Bifidobacterium (4.88∓0.42, P<0.05), Peptococcus (6.19∓0.32, P<0.01) and Lactobacillus (4.73∓0.47, P<0.001) all increased significantly and Eubacterium (1.01∓0.29, P<0.01) and Clostridium (0.87∓0.31, P<0.01) decreased in patients with Crohn's disease. The positivity rates of bacterial culture were consistent with the results of quantitative analysis of the fecal flora. The changes in fecal flora did not show a significant correlation with these inflammatory markers.</p><p><b>CONCLUSION</b>IBD patients have fecal flora imbalance compared with the healthy controls, and this imbalance may contribute to the occurrence and progression of IBD. The decline of Eubacterium contributes to the occurrence and development of IBD.</p>
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Adult , Female , Humans , Male , Bacteria , Bacteroides , Bifidobacterium , Biomarkers , Clostridium , Colitis, Ulcerative , Microbiology , Crohn Disease , Microbiology , Enterococcus , Eubacterium , Feces , Microbiology , Inflammatory Bowel Diseases , Microbiology , Lactobacillus , Peptococcus , SaccharomycesABSTRACT
Objective To investigate the diagnostic value of computed tomography,X ray enterography and digestive endoscopy for intestinal Crohn's disease in active and chronic phase.Methods The clinical data of 39 patients with Crohn's disease who were admitted to the Subei People's Hospital from June 2008 to August 2011 were retrospectively analyzed.All patients were divided into the active phase group (28 patients) and the chronic phase group (11 patients).The results of computed tomography,X ray enterography and digestive endoscopy of the 2 groups were compared.The accuracy of the 3 diagnostic methods was assessed by consulting the operative findings.The enumeration data were analyzed using the chi-square test.Results The incidences of intestinal wall stratification,intesitnal edema strap,severe enhancement,ulcers,intestinal stenosis,intestinal fistula,phlegmon,swollen lymph nodes and comb sign in patients with active phase of Crohn's disease were significantly higher than those with chronic phase of Crohn's disease (x2 =10.700,3.954,22.025,7.661,10.700,7.661,6.810,7.661,4.592,P＜0.05).The incidences of intestinal wall thickening,intramural fat,mild enhancement,unenhancement,inflammatory polyps,abscesses and inflammatory masses in patients with chronic phase of Crohn's disease were significantly higher than those with active phase of Chrohn's disease (x2=17.475,11.345,18.050,5.366,22.856,12.662,5.846,P ＜ 0.05).Computed tomography was effective in detecting intestinal wall thickening and extraintestinal complications of Crohn's disease,but it was difficult in demonstrating ulcers and inflammatory polyps.X ray enterography and digestive endoscopy were effective in detecting ulcers and inflammatory polyps,but they were difficult in detecting intestinal wall thickening and extraintestinal complications of Crohn's disease.Conclusion Computed tomography combined with X ray enterography and digestive endoscopy is helpful in demonstrating the presentations of Crohn's disease in active and chronic phase.
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Objective To investigate the expressions of EGFR,Her-2 and VEGF in cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma,as well as its clinic value of carcinogenesis,progression and metastasis in ccrvical squamous cell carcinoma.Methods EGFR,Her-2 and VEGF were evaluated by immunohistochemistry in tissues from normal cervix,CIN and squamous cell carcinoma.Results The expressions of EGFR,Her-2 and VEGF were negative in normal cervix.The positive rate of EGFR,Her-2 and VEGF in CIN tissues were 35.0 ％ (14/40),37.5 ％ (15/40),42.5 ％ (17/40),while in cervical carcinoma tissues were 70.0 ％ (35/50),78.0 ％ (39/50),76.0 ％ (38/50) respectively,which had statistical significance.There was relationship between the expressions of EGFR,Her-2,VEGF proteins with pathological grade andlymph node metastasis of squamous cell carcinoma.The expressions of Her-2 and VEGF correlated with the clinical stage of quamous cell carcinoma.Conclusion The expressions of EGFR,Her-2 and VEGF may be correlated with the occurrence,development and metastasis of cervical carcinoma.It may be used as an important marker to evaluate the malignant degree of cervical carcinoma and it can be helpful in the treatment of cervical carcinoma.
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Objective To investigate clinical,endoscopic and CT characteristics in Crohn's disease (CD),intestinal tuberculosis(ITB) and primary small intestinal lymphoma (PSIL).Methods In this study,39 cases of CD,24 cases of ITB and 23 cases of PSIL were retrospectively analyzed.Clinical and CT data were collected in all patients,23 CD cases,20 ITB cases and 20 PSIL cases underwent endoscopic exam.Chi-square tests or analysis of variance were used to evaluate and differentiate characteristics.Results Diarrhea,perianal disease,intestinal obstruction occurred significantly more in CD than in ITB and PSIL (x2 =10.134,6.769,8.000,P ＜ 0.05).Febrility,night sweating,pulmonary tuberculosis and ascites occurred more in ITB than in CD and PSIL (x2 =25.696,19.194,35.133,P ＜0.05).Abdominal mass,hematochezia and enterobrosis occurred more in PSIL than in CD and ITB (x2 =19.562,17.708,12.647,P＜0.05).Longitudinal ulcer,cobblestone sign were found more in CD than in ITB and PSIL(x2 =6.283,11.592,P ＜ 0.05).Transverse ulcer and rodent ulcer were found more in ITB than in CD and PSIL(x2 =15.633,19.686,P ＜ 0.05),but lump eminentia were found more in PSIL than in CD and ITB(x2 =26.120,P ＜0.05).Layering thickening,mural gas,fat,edema,enteric cavity stenosis,abscess were discovered more in CD than in ITB and PSIL (x2 =17.472,10.346,7.773,6.867,16.325,10.994,P＜0.05),single layer thickening and hollow lymph nodes were discovered more in ITB than in CD and PSIL(x2 =17.997,12.475,P ＜ 0.05).Multi segmental lesions was discovered more in CD and ITB than in PSIL (x2 =28.460,P ＜ 0.05),while single segmental lesions,mural single eccentric layer thickening and intussusceptions were discovered more in PSIL than in CD and PSIL (x2 =28.460,P ＜0.05).The intestinal wall thickening and lymph nodes enlargement in ITB and PSIL were higher than the CD (F =8.661,7.166,P ＜ 0.05),while the intestinal wall enhancement at CT imaging in PSIL was lower than CD and ITB (F =10.179,P ＜ 0.05).Conclusions Comprehensive analysis made on clinical,endoscopic and CT features of CD,ITB and PSIL may facilitate correct diagnosis.
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ObjectiveTo investigate the CT and MRI characteristic features of neuroendocrine carcinoma in paranasal sinuses.MethodsCT and MRI findings of 10 patients with proved neuroendocrine carcinoma by pathology were retrospectively reviewed. All patients underwent plain and enhanced MRI scanning,and 9 patients also underwent CT manning.ResultsThere were 5 males and 5 females with mean age of (48 ± 9 ) years old,ranging from 27 to 57 years.The treatment time after symptoms onset ranged from 1 to 4 months,with the median of 2 months.Clinical symptoms were headache and vision loss,hyposmia and yellow nasal discharge,and exophthalmos.The lesions were located in the ethmoidal sinus ( n =6 ),maxillary sinus ( n =2),and bilateral sphenoid sinus ( n =5 ).The lesions were symmetrical in the sphenoid sinus.Pathology type included typical carcinoid tumor ( n =1 ),atypical carcinoid ( n =1 ),and neuroendocrine carcinoma not otherwise specified ( n =8 ). Immunohistochemical staining showed that neurospecific enolase,synaptophysin,cytokeratin and P53 were all positive.On CT images,lesions showed isointensity (n =1 ),iso- to hypointense (n =4 ),and iso- to hyperintense (n =4 ) with hypointense or hyperintense spots.Bone changes included bony absorption and sclerosis ( n =1 ) with a clear margin in typical carcinoid tumor,and moth-eaten bone destruction in other 8 cases( n =8).The lesions were isointense on T1-weighted images,and isointense (n =4) or mixed iso- to hyperintense on T2-weighted images (n =6).Lesions showed mild to medium heterogeneous enhancement ( n =7 ) or marked enhancement ( n =3 )on gadolinium-enhanced images.Time-signal intensity curve ( TIC ) showed plateau type in 2 cases.The aggressive nature of the tumors was demonstrated by invasion of adjacent structures,involvement of nasal cavity( n =9 ),orbits ( n =7 ),pterygopalatine fossa ( n =4 ),ethmoidalsinus and sphenoid ( n =3 ),clivus ossis occipitalis(n =2),cavernous sinus and internal carotid canal(n =2),optic canal(n =2),jugular fossa ( n =1 ),anterior fossa ( n =1 ),apex partis petrosae ossis temporalis ( n =1 ),meninges ( n =1 ),temporal fossa and infratemporal fossa ( n =1 ),pharyngonasal cavity and parapharyngeal space ( n =1 ).ConclusionsThere are different CT features in different pathological types of neuroendocrine carcinoma of the paranasal sinuses,and MRI can demonstrate the invasive extent accurately. CT combined MRI can provide more comprehensive information in the diagnosis and therapy.
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Objective To investigate the MSCT features of the renal cell carcinoma associated with XP11.2 translocation-TFE gene fusion ( XP11.2-TFE Ca).Methods The MSCT features of XP11.2-TFE Ca in six patients were retrospectively analyzed,which were confirmed by postoperative histopathology.All the tumor features were recorded and compared to the histopathological findings.Variance test analysis was performed to compare the CT values among tumor,normal renal cortex and normal renal medulla.Results XP11.2-TFE Ca appeared as a solitary lesion in all the 6 patients,which limited in the medulla in 3 patients and infiltrated both medulla and renal pelvis in other 3 patients.The tumor diameter ranged from 3.8 to 5.2 cm [mean diameter,(4.2 ± 1.3) cm],And the adjacent renal cortex was compressed or involved.Four lesions were oval,2 lesions were irregular shape.Tumor capsule showed in all lesions in the six patients.Cystic component and retroperitoneal lymph node metastasis respectively occurred in one patient.In all lesions,calcification was not detected.On unenhanced CT scan phase,the CT values of the normal cortex,normal medulla and XP11.2-TFE Ca were (42 ±5),(38 ±4) and (48 ±4) HU respectively,with no significant statistical difference ( F =1.267,P ＞ 0.05 ) ; on cortical nephrographic phase after contrast injection,they were ( 174 ± 10 ),( 72 ± 8 ) and ( 100 ± 9) HU respectively,with significant statistical difference among the three groups (F =6.588,P ＜ 0.01) ; on parenchymal nephrographic phase,they were (207 + 12),(109 +8) and ( 121± 11) HU respectively,with significant statistical difference (F =7.172,P＜0.01) ; and on the excretory phase,they were (148 ± 12),(67 ±8) and (83 ±7) HU respectively,with significant statistical difference ( F =2.678,P ＜ 0.05 ).On each phase of contrast-enhanced MSCT scan,the enhancement of XP11.2-TFE Ca was higher than that of the medulla and lower than that of the cortex.Conclusions XP11.2-TFE Ca had some characteristic MSCT features.Comprehensive analysis of its MSCT features may help for improving the diagnosis.
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Objective To study the white matter fiber integrity in patients with posttraumatic stress disorder by using MR diffusion tensor imaging (DTI).Methods Twelve patients with posttraumatic stress disorder and twelve healthy volunteers were examined with MR T1WI、T2WI and DTI.Fractional anisotropy maps、directionally encoded color maps were created with the software of DTV-II.Fractional anisotropy (FA) were measured in the genu (anterior),body and splenium (posterior) of corpus callosum,horizontal part and posterior part of the bilateral cingulste fibers.Results In normal volunteers group,FA measurements in white matter regions were normal and reconstructed FA images and directionally encoded color(DEC) maps could display main white fibers in normal controls.The FA value of the splenium (posterior) of corpus callosum and horizontal part of the bilateral cingulate fibers was significant lower in PTSD patients than in normal controls (P<0.05).Conclusions The fiber bundle of the limbic system in patients with PTSD may have structural abnornalities.