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1.
Chinese Journal of Urology ; (12): 712-716, 2021.
Article in Chinese | WPRIM | ID: wpr-911101

ABSTRACT

Objective:To investigate the diagnostic performance of repeat biopsy 68Ga-PSMA PET/CT to distinguish between benign and malignant prostate disease. Methods:The clinical data and medical imaging of thirty-nine patients underwent repeat prostate biopsy were analyzed respectively in this study. The median age of patients was 65 years (range 46-81 years), the median PSA level was 11.0ng/ml (range 5.4-49.8 ng/ml), f/tPSA was 0.15(0.01-16.50)ng/ml, prostate volume was 43.80(7.79-108.63)ml, and PSA density was 0.24(0.09-2.31)ng/ml 2. All patients underwent pre-biopsy 68Ga-PSMA PET/CT and the standard transrectal ultrasound-guided systematic prostate biopsy. Based on the biopsy results, 68Ga-PSMA PET/CT images of all patients were visually and semi-quantitatively analyzed. By visual analysis, 68Ga-PSMA uptake in prostate was defined as focal, multimodal and inhomogeneous, and then the detection rate of prostate cancer in each subgroup was analyzed. The value of the ROC curve in the diagnosis of prostate cancer was analyzed based on the SUV max of prostate cancer(SUV max), tumor-to-normal-prostate background(SUV T/BGp)as semi-quantitative parameters of 68Ga-PSMA PET/CT. Results:Prostate cancer was detected in 18 patients (46.2%) and 12 patients (30.8%) had clinically significant disease. There were 11, 5 and 2 patients with prostate cancer respectively in men with a focal (12 patients), multifocal(7 patients) and inhomogeneous (20 patients) 68Ga-PSMA uptake. The ROC analysis revealed a SUV max 5.3 and SUV T/BGp1.8 as an optimal cut-off level to distinguish between non-prostate cancer and prostate cancer in 68Ga-PSMA PET/CT, the sensitivity and specificity were 100.0% and 85.7% for SUV max (AUC=0.979), 83.3% and 90.5% for SUV T/BGp (AUC=0.915). Conclusions:Pre-biopsy 68Ga-PSMA PET/CT could help to distinguish between benign and malignant prostate disease before repeat prostate biopsy and detect the foci of prostate cancer.

2.
Article in Chinese | WPRIM | ID: wpr-870674

ABSTRACT

Objective:To compare the clinical effects of three laparoscopic conservative surgical procedures for tubal pregnancy.Methods:From January 2016 to June 2017, 296 patients with tubal pregnancy who underwent laparoscopic fallopian tube window embryo retrieval in our hospital were included in the study. Ninety six patients received meshmental suture combined with tubal incision and suture (group A), 102 patients receive mesentery suture (group B) and 98 patients received conventional surgery (group C). All patients in the three groups were given methotrexate 25 mg injected to the mesentery of the fallopian tube after surgery. The general conditions, treatment effects and postoperative conditions of the three groups were compared. Statistical analysis was performed using analysis of variance or χ 2 test. Results:There was no significant difference in general conditions among the three groups ( P>0.05). The surgical success rate of groups A and B were significantly higher than that of the group C [99.0%(95/96),99.0%(101/102),93.9%(92/98);χ 2=6.52, P=0.04]; the intraoperative blood loss of groups A and B was significantly lower than that in the group C [(30.6±10.9)ml, (30.9±11.6)ml, (63.5±21.8)ml; F=144.18, P<0.01]. At three months after operation, the tubal patency (patency, tortuous, obstruction) of the affected side of the group A was significantly better than that of the groups B and C [group A:81.1%(77/95),13.7%(13/95),5.3%(5/95); group B: 62.4%(63/101),21.8%(22/101),15.8%(16/101);group C:55.4%(51/92),26.1%(24/92),18.5%(17/92); χ 2=15.64, P<0.01]. Eighteen months after surgery, the fallopian pregnancy rate and secondary infertility rate of the affected side of the tubal in group A were significantly lower than those in groups B and C [group A:7.3%(7/96) and 12.5%(12/96),group B: 17.6%(18/102) and 21.6%(22/102), group C: 19.4%(19/98) and 28.6%(28/98); χ 2=6.56, P=0.04; χ 2=7.60, P=0.02]. The intrauterine pregnancy rate of tree groups was similar [45.8%(44/96),35.3%(36/102),33.7%(33/98); χ 2=3.59, P=0.17]; none of the patients in the three groups had persistent ectopic pregnancy, and no serious adverse reactions occurred during treatment. Conclusions:Laparoscopic salpingotomy and tubal incision and laparoscopic suture combined with tubal incision suture are easy to be performed with less bleeding, high surgical success rate and high recanalization rate of fallopian tubes, which deserves clinical promotion.

3.
Article in Chinese | WPRIM | ID: wpr-868864

ABSTRACT

Ultrasonography plays an important role in liver surgery of colorectal cancer liver metastases. Recently, besides grey and doppler ultrasonography, contrast-enhanced ultrasonography, elastography and infusion-image technique has developed and attracted increasing interest. Intraoperative ultrasonography is applied for tumor detection, localization and characterization. It is also used for liver resection and planning surgical strategy, which may improve surgical effect and safety. This article discussed the application of intraoperative ultrasonography in liver resection of colorectal cancer liver metastases.

4.
J Cancer Res Ther ; 2019 Aug; 15(4): 773-783
Article | IMSEAR | ID: sea-213430

ABSTRACT

Background: Lyso-thermosensitive liposomal doxorubicin (LTLD, ThermoDox) consists of doxorubicin encapsulated contained within a heat-sensitive liposome. Aims and Objectives: We sought to evaluate whether the use of combined radiofrequency ablation (RFA) and LTLD would result in larger coagulation volume and longer overall survival (OS) compared with the use of RFA alone in patients with 3–7 cm unresectable hepatocellular carcinoma (HCC). Materials and Methods: Between 2010 and 2012, 22 HCC patients were randomly assigned to one of two treatments in our center: (1) ultrasound-guided percutaneous RFA plus intravenous (IV) infusion of LTLD (combination, n = 11) or (2) RFA plus IV dummy (RFA, n = 11). Four patients withdrew from the study, and the remaining 18 patients entered the final analysis. There were 14 male and 4 female patients with an average age of 61.1 ± 9.3 years (range: 40–73 years). The average tumor size was 4.2 ± 1.0 cm (range: 3.1–6.1 cm). One-month enhanced computed tomography was used to evaluate the ablation efficacy and coagulation volume after RFA. Regular follow-up after RFA was performed to assess toxicity, local response rates, and OS rates. Results: A major complication (empyema) occurred in one case in the combination group. Combination treatment region did not induce any additional toxicity beyond doxorubicin. The primary ablation success rate was 93.3% (14/15 tumors) in the combination group and 77.8% (7/9 tumors) in the RFA group (P = 0.308). The difference in coagulation volume between pre- and post-RFA in the combination group was significantly larger than that of the RFA group (105.7 ± 73.8 cm 3 vs. 37.3 ± 8.5 cm 3, P = 0.013). The follow-up period ranged from 11 to 80 months (average: 49.1 ± 24.8 months). The local progression rate was 6.7% (1/15 tumors) in the combination group and 22.2% (2/9 tumors) in the RFA group. The mean OS for the combination group was 68.5 ± 7.2 months, which was significantly greater compared with the RFA group (46.0 ± 10.6 months, P = 0.045). Conclusions: RFA with heat target delivery chemotherapy facilitated better tumor coagulation necrosis without additional toxicity. This combined treatment may improve the clinical efficacy of RFA or free doxorubicin and prolong survival in patients with medium to large HCC

5.
Article in Chinese | WPRIM | ID: wpr-734449

ABSTRACT

Objective To investigate the value of 68Ga-prostate specific membrane antigen (PSMA)-617 PET/CT in predicting high-risk prostate cancer.Methods From May 2016 to January 2017,30 patients (median age 67 years) with biopsy-proven prostate cancer were included.The 68Ga-PSMA-617 PET/CT images and clinical data of all patients were analyzed retrospectively.According to prostate cancer risk stratification criteria of National Comprehensive Cancer Network (NCCN) Guidelines (including Gleason scores,prostate specific antigen (PSA)),all patients were classified into low-moderate-risk group and high-riak group.PET images were analyzed semi-quantitatively and maximum standardized uptake value (SUVmax) of primary prostate cancer was measured.SUVmax of 68Ga-PSMA-617 PET/CT was used to establish logistic regression model for predicting high-risk prostate cancer,and the diagnostic efficiency of the model was evaluated by receiver operating characteristic (ROC) curve analysis.Results The median Gleason score of 30 patients was 7.5 (7,9),and the median PSA was 34.0 (19.4,119.1) μg/L,including 9 patients with PSA≤ 20 μg/L and 21 patients with PSA>20 μg/L.According to the NCCN Guidelines,there were 24 patients with high-risk prostate cancer and 6 patients with low-moderate-risk prostate cancer.SUVmax was higher in high-risk group than that in low-moderate-risk group (14.2 (11.4,23.1) vs 7.9 (3.8,13.1);u =118,P< 0.05).Logistic regression model established with SUVmax could effectively predict high-risk prostate cancer with the area under ROC curve of 0.819.When the cut-off value was set as 0.73,the sensitivity and specificity of the model were 87.5%(21/24) and 4/6 respectively.Conclusion SUVmax of 68Ga-PSMA-617 PET/CT can be used as an imaging biomarker for predicting high-risk prostate cancer.

6.
Article in Chinese | WPRIM | ID: wpr-745143

ABSTRACT

Objective To retrospectively analyze contrast-enhanced ultrasound ( CEUS ) manifestations of neuroendocrine tumors ( NETs) liver metastases ,and explore the relationship between CEUS parameters and differentiation of NETs . Methods From January 2014 to June 2018 ,36 patients who had been performed CEUS due to liver metastasis of NETs with pathological diagnosis and immunohistochemical staining results were enrolled in this study . The CEUS findings of NETs liver metastases were summarized . According to the Ki-67 index ,CgA results ,and the stage G ,the patients were divided into Ki-67>20% group and Ki-67≤20% group ,CgA negative group and CgA positive group ,and group G1+G2 and group G3 ,respectively . The CEUS parameters of NETs liver metastases between the above groups were compared . Results In 36 lesions ,during the arterial phase of CEUS ,66 .7% (24/36) showed hyperenhancement ,16 .7% (6/36) isoenhancement ,13 .9% (5/36) rim-like enhancement ,and 5 .6% ( 2/36 ) hypoenhancement ; During the portal phase , 13 .9% ( 5/36 ) showed hyper or iso enhancement ,86 .1% (31/36) showed hypoenhancement . The average washout time was ( 67 .5 ± 56 .1)s ,of which 5 (13 .9% ) lesions were washed out after 120 s . The mean starting washout time was statistically different between the CgA negative group and the positive group[(91.6±81.5)svs(60.1±38.7)s,P =0 .001] . There was no statistically significant difference in all observations between the group of Ki-67≤20% and >20% ,group G1+G2 and group G3( P >0 .05) . Conclusions CEUS of NETs liver metastasis has certain characteristics ,among which hyperenhancement is its main enhancement mode ,and some lesions have a longer wash out time . The relationship with the degree of differentiation needs further investigation .

7.
Article in Chinese | WPRIM | ID: wpr-802046

ABSTRACT

Objective:To systemically study the chemical constituents of n-butanol fraction from Lysimachia capillipes. Method:The whole plant of L. capillipes was crushed into power,extracted by 70% methanol,concentrated under reduced pressure,and then its n-butanol extract was obtained by fractional extraction. The compounds from n-butanol fraction were isolated and purified by macroporous resin column chromatography,medium pressure ODS,silica gel,Sephadex LH-20 and preparative HPLC. Their structures were identified on the basis of spectral analysis and comparison with literature data. Result:Fifteen compounds including 6 saponins and 9 flavonoid glycosides were isolated from L. capillipes,and were identified as ascapilliposide B(1) and capilliposide C(2),kaempferol-3-O-β-D-xylopyranosyl(1→3)-[4-O-E-p-coumaroyl-α-L-rhamnopyranosyl(1→2)] [β-D-glucopyranosyl(1→6)]-β-D-galactopyranoside-7-O-α-L-rhamnopyranoside(3),kaempferol-3-O-{[β-D-xylopyranosyl(1→3)-α-L-rhamnopyranosyl(1→6)] [α-L-rhamnopyranosyl(1→2)]}-β-D-3-trans-p-coumaroylgalactopyranoside (4),capilliposide K (5),3β-O-{α-L-rhamnopyranosyl-(1→2)-O-β-D-glucopyranosyl-(1→4)-[O-β-D-glucopyranosyl-(1→2)]-α-L-arabinopyranosyl)}-16α-hydroxyolean-28,13β-olide (6),capilliposide I(7),quercetin-3-O-(2″,6″-di-O-α-rhamnopyranosyl)-β-galactopyranoside(8),kaempferol-3-O-{[β-D-xylopyranosyl(1→3)-α-L-rhamnopyranosyl(1→6)] [α-L-rhamnopyranosyl-(1→2)]}-β-D-galactopyranoside(9),kaempferol-3-O-[2-glucopyranosyl(1→3)rhamnopyranosyl-6-rhamnopyranosyl]-β-D-galactopyranoside(10),kaempferol-3-O-α-L-rhamnopyranosy-(1→2)-[α-L-rhamnopyranosy-(1→6)]-β-D-galactopyranoside(11),capilliposide I(12),kaempferol-3-O-{(β-D-glucopyranosyl-(1→3)-[4-O-(E-p-coumaroyl)]-α-L-rhamnopyranosyl-(1→6)-(β-D-galactopyranoside)}-7-O-α-L-rhamnopyranoside (13),kaempferol-3-O-{[β-D-glucopyranosyl(1→3)]-4-O-(E-p-coumaroyl)}-α-L-rhamnopyranosyl(1→6)-β-D-glucopyranoside-7-O(4-O-acetyl)-α-L-rhamnopyranoside (14),and (3β,20S,23S,24R)-3,20,23,24,25,29-hexahydroxydammaran-21-oic acid-21,23-lactone 3-O-β-D-glucopyranosyl-(1→6)-β-D-gluco-pyranoside(15). Conclusion:The compounds 3,4,6,9,10,13-15 were isolated from this plant for the first time.

8.
Article in Chinese | WPRIM | ID: wpr-800412

ABSTRACT

Objective@#To investigate the use of conventional MR imaging to guide treatment in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall.@*Methods@#The clinical data of patients who were treated in the Ningbo Huamei Hospital, University of the Chinese Academy of Sciences between January 2017 and January 2018 were analyzed. These patients were divided into two groups: patients with acute cholecystitis (n=139) and patients with viral hepatitis combined with cholecystolithiasis (n=67). Differences in the imaging signs in standardized upper abdominal contrast enhanced MRI examinations were retrospectively analyzed.@*Results@#The imaging signs, including stone location, continuity of gallbladder mucosa, exudation in peri-gallbladder space, edema of intrahepatic portal area showed significant differences between the two groups (all P<0.05). On stratification analysis, the type of thickened gallbladder wall, background of liver parenchyma and extent of edema in intrahepatic catchment area also showed significant differences (all P<0.05). The imaging signs, including non-gallbladder neck ductal stones, concentric thickening of gallbladder wall, continuous mucous membrane in gallbladder and no peri-gallbladder space exudation but diffuse edema of intrahepatic catchment area supported the diagnosis of viral hepatitis combined with gallstones. The imaging signs, including discontinuity of gallbladder mucosa, exudation of peri-gallbladder space, diffuse edema of gallbladder wall without a cirrhotic background and edema in intrahepatic portal area supported the diagnosis of acute calculous cholecystitis of gallbladder.@*Conclusions@#Routine upper abdominal contrast enhanced MRI plays an important role in demonstrating the underlying cause of gallbladder wall diffuse edema thickening in patients with gallstones. It provides an important reference for the choice of clinical treatment pathway.

9.
Article in Chinese | WPRIM | ID: wpr-797009

ABSTRACT

Objective@#To investigate the value of shear wave elastography(SWE) to evaluate local advanced rectal cancer after neoadjuvant radiochemotherapy.@*Methods@#In a retrospective study, endorectal ultrasound(ERUS) and endorectal SWE were performed in 73 patients with local advanced rectal cancer before and after neoadjuvant radiochemotherapy. The mean and maximum values of Young′s modulus for SWE to evaluate the lesions before and after neoadjuvant radiochemotherapy were recorded. According to the postoperative pathological T stage, the lesions were divided into reduction of T stage group and non-reduction of T stage group. The efficacy of ERUS in diagnosing reduction of T stage was calculated, and the differences of the mean and maximum values of Young′s modulus between reduction of T stage group and non-reduction of T stage group was calculated, and the differences between the two groups were compared. ROC curves were constructed by the difference of mean and maximum Young′s modulus of lesions before and after neoadjuvant radiochemotherapy, respectively, to evaluate the diagnostic value of the difference in predicting reduction of T stage.@*Results@#A total of 57 cases had reduction of T stage after neoadjuvant radiochemotherapy (57/73, 78.1%). The mean and maximum values of Young′s modulus before and after neoadjuvant radiochemotherapy were compared, and the differences were statistically significant(all P<0.01). After neoadjuvant radiochemotherapy, the values of Young′s modulus of the lesions increased with the increase of pT stage. Compared with the mean values of Young′s modulus of the lesions in pT3 stage, the differences of the mean values of Young′s modulus of the lesions in pT0, pT1 and pT2 stages were statistically significant(all P<0.01). Compared with the maximum values of Young′s modulus of the lesions in pT3 stage, the differences of the maximum values of Young′s modulus of the lesions in pT0 and pT1 stage were statistically significant(all P<0.01). The differences of the mean value and the maximum value of Young′s modulus in the reduction of T stage group and the non-reduction of T stage group was statistically significant(all P<0.01). The ROC curve was established and determined by calculation. Taking the average difference of 34.7 kPa as the best diagnostic threshold, the average hardness of the lesion after neoadjuvant radiochemotherapy decreased more than 34.7 kPa to diagnose the reduction of T stage, the sensitivity, specificity and accuracy were 87.7%, 93.8% and 89.0%, respectively. Compared with ERUS, the difference was statistically significant(P=0.032).@*Conclusions@#Shear wave elastography is an effective technology to help ERUS in evaluating the lesions of rectal cancer after neoadjuvant radiochemotherapy and has a promising future.

10.
Article in Chinese | WPRIM | ID: wpr-824505

ABSTRACT

0bjective To investigate the use of conventional MR imaging to guide treatment in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall.Methods The clinical data of patients who were treated in the Ningbo Huamei Hospital.University of the Chinese Academy of Sciences between January 2017 and January 2018 were analyzed.These patients were divided into two groups:patients with acute cholecystitis(n=139)and patients with viral hepatitis combined with cholecys-tolithiasis(n=67).Differences in the imaging signs in standardized upper abdominal contrast enhanced MRI examinations were retrospectively analyzed.Results The imaging signs,including stone location,continuity of gallbladder mucosa,exudation in peri-gallbladder space,edema of intrahepatic portal area showed significant differences between the two groups(all P<0.05).On stratification analysis,the type of thickened gallbladder wall.background of liver parenchyma and extent of edema in intrahepatic catchment area also showed significant differences(all P<0.05).The imaging signs,including non-gallbladder neck ductal stones,concentric thickening of gallbladder wall,continuous mucous membrane in gallbladder and no peri-gallbladder space exudation but diffuse edema of intrahepatic catchment area supposed the diagnosis of viral hepatitis combined with gallstones.The imaging signs.including discontinuity of gallbladder mucosa.exudation of peri-gallbladder space,diffuse edema of gallbladder wall without a cirrhotic background and edema in intrahepatic portal area supposed the diagnosis of acute calculous cholecystitis of gallbladder.Conclusions Routine upper abdominal contrast enhanced MRI plays an important role in demonstrating the underlying cause of gallbladder wall diffuse edema thickening in patients with gallstones.It provides an important reference for the choice of clinical treatment pathway.

11.
Article in Chinese | WPRIM | ID: wpr-781260

ABSTRACT

OBJECTIVE@#To investigate the regulatory role of Musashi-1 (MSI1) in the proliferation and growth of hepatocellular carcinoma (HCC) cells.@*METHODS@#We examined the expression of MSI1 in HCC and paired adjacent tissues from 24 patients using immunohistochemistry and Western blotting. A MSI1-expressing vector was constructed and stably transfected into HepG2 cells, and short hairpin RNAs (shRNAs) that targeted MSI1 mRNA were ligated into the vector and stably transfected in Huh7 cells. The effects of MSI1 overexpression and silencing on the proliferation, viability and cell cycle of HepG2 cells were investigated using flow cytometry or MTT assay. The expressions of PCNA, cyclin D1, APC and β-catenin in the HCC cells were detected with Western blotting.@*RESULTS@#MSI1 expression was significantly up-regulated in HCC tissues as compared with that in the adjacent tissues. Overexpression of MSI1 in HepG2 cells resulted in significantly enhanced cell growth ( < 0.01) and significantly reduced G0/G1 phase cells from (58.42±3.18)% to (40.67±1.22)% and increased S phase cells from (28.51± 1.93)% to (40.06±1.92)% ( < 0.01), causing also increases in the expressions of PCNA and Cyclin D1. Knockdown of MSI1 in Huh7 cells obviously inhibited the cell growth and caused cell cycle arrest at the G1/S phase ( < 0.01) with reduced protein expressions of PCNA and cyclin D1. Overexpression of MSI1 in HepG2 cells also down-regulated the expression of APC and up-regulated the expression of β-catenin protein, while MSI1 knockdown caused reverse changes in Huh7 cells.@*CONCLUSIONS@#MSI1 promotes the progression of HCC through positive modulation of cell growth and cell cycle the Wnt/β-catenin pathway.


Subject(s)
Carcinoma, Hepatocellular , Cell Cycle , Cell Proliferation , Hep G2 Cells , Humans , Liver Neoplasms , Nerve Tissue Proteins , Metabolism , RNA-Binding Proteins , Metabolism
12.
Article in Chinese | WPRIM | ID: wpr-772129

ABSTRACT

OBJECTIVE@#To investigate the interaction between interleukin-17 (IL-17) and interferon-γ (IFN-γ) and how their interaction affects the growth of mouse hepatoma Hepa1-6 cells.@*METHODS@#Hepa1-6 cells treated with IL-17 and IFN-γ either alone or in combination were examined for changes in cell proliferation using MTT assay and in cell cycle distribution using flow cytometry. Western blotting was used to detect the protein expression levels of proliferating cell nuclear antigen (PCNA), cyclin D1, P21 and P16 and the phosphorylation of p38MAPK, ERK1/2 and Stat1 in the cells.@*RESULTS@#Compared with control group, IFN-γ treatment obviously inhibited the growth and proliferation of Hepa1-6 cells, induced cell cycle arrest at G0/G1 phase, reduced the protein expression of PCNA and cyclin D1, and increased the protein expression of P21. IL-17 alone had no effect on the growth of Hepa1-6 cells. In the combined treatment, IL-17 significantly antagonized the effects of IFN-γ. Compared with those treated with IFN-γ alone, the cells with the combined treatment showed significantly decreased G0/G1 cell population, increased the protein expressions of PCNA and cyclin D1, and decreased the protein expression of P21. IL-17 significantly inhibited IFN-γ-induced phosphorylation of p38MAPK and ERK1/2 without affecting the phosphorylation of Stat1.@*CONCLUSIONS@#IL-17 obviously reverses the antitumor effects of IFN-γ to promote the proliferation of mouse hepatoma cells and accelerate the development of hepatocellular carcinoma.


Subject(s)
Animals , Carcinoma, Hepatocellular , Metabolism , Pathology , Cell Cycle , Cell Line, Tumor , Cell Proliferation , Cyclin D1 , Metabolism , Cyclin-Dependent Kinase Inhibitor p21 , Metabolism , Interferon-gamma , Interleukin-17 , Pharmacology , Liver Neoplasms , Metabolism , Pathology , Mice , Neoplasm Proteins , Metabolism , Proliferating Cell Nuclear Antigen , Metabolism
13.
Article in Chinese | WPRIM | ID: wpr-791319

ABSTRACT

Objective To investigate the value of shear wave elastography ( SWE) to evaluate local advanced rectal cancer after neoadjuvant radiochemotherapy . Methods In a retrospective study ,endorectal ultrasound( ERUS) and endorectal SWE were performed in 73 patients with local advanced rectal cancer before and after neoadjuvant radiochemotherapy . T he mean and maximum values of Young′s modulus for SWE to evaluate the lesions before and after neoadjuvant radiochemotherapy were recorded . According to the postoperative pathological T stage ,the lesions were divided into reduction of T stage group and non‐reduction of T stage group . T he efficacy of ERUS in diagnosing reduction of T stage was calculated ,and the differences of the mean and maximum values of Young′s modulus between reduction of T stage group and non‐reduction of T stage group was calculated ,and the differences between the two groups were compared . ROC curves were constructed by the difference of mean and maximum Young′s modulus of lesions before and after neoadjuvant radiochemotherapy ,respectively ,to evaluate the diagnostic value of the difference in predicting reduction of T stage . Results A total of 57 cases had reduction of T stage after neoadjuvant radiochemotherapy ( 57/73 ,78 .1% ) . The mean and maximum values of Young′s modulus before and after neoadjuvant radiochemotherapy were compared ,and the differences were statistically significant ( all P < 0 .01) . After neoadjuvant radiochemotherapy ,the values of Young′s modulus of the lesions increased with the increase of pT stage . Compared with the mean values of Young′s modulus of the lesions in pT3 stage , the differences of the mean values of Young′s modulus of the lesions in pT 0 ,pT1 and pT2 stages were statistically significant ( all P < 0 .01 ) . Compared with the maximum values of Young′s modulus of the lesions in pT3 stage ,the differences of the maximum values of Young′s modulus of the lesions in pT0 and pT1 stage were statistically significant( all P <0 .01) . T he differences of the mean value and the maximum value of Young′s modulus in the reduction of T stage group and the non‐reduction of T stage group was statistically significant ( all P < 0 .01 ) . T he ROC curve was established and determined by calculation . Taking the average difference of 34 .7 kPa as the best diagnostic threshold ,the average hardness of the lesion after neoadjuvant radiochemotherapy decreased more than 34 .7 kPa to diagnose the reduction of T stage ,the sensitivity ,specificity and accuracy were 87 .7% ,93 .8% and 89 .0% ,respectively . Compared with ERUS , the difference was statistically significant ( P = 0 .032 ) . Conclusions Shear wave elastography is an effective technology to help ERUS in evaluating the lesions of rectal cancer after neoadjuvant radiochemotherapy and has a promising future .

14.
Article in Chinese | WPRIM | ID: wpr-706311

ABSTRACT

Objective To investigate the value of real-time virtual navigation system (RVS) combined with CEUS in guiding radiofrequency ablation (RFA) therapy of neonatal or recurrent lesions of hepatocellular carcinoma (HCC).Methods Totally 111 patients with neonatal or recurrent lesions of HCC after RFA therapy were enrolled.Seventy-eight patients with 86 lesions (77 neonatal lesions and 9 recurrent lesions) underwent RFA guided by RVS combined with CEUS (RVS combined with CEUS group),and 33 patients with 38 lesions (26 neonatal lesions and 12 recurrent lesions) underwent RFA guided by CEUS alone (control group).The precise localization,inactivation rate and local recurrence rate between the two groups were compared.Results Eighty-four lesions (84/86,97.67%) in RVS combined with CEUS group and 25 lesions (25/38,65.79%) in control group were clearly showed and localized (P<0.001).One month after RFA therapy,the tumor inactivation rate in RVS combined with CEUS group and control group was 95.35 % (82/86) and 76.31% (29/38),respectively (P=0.003).The local recurrence rate in RVS combined with CEUS group was 8.14% (7/86),while was 36.84% (14/38) in control group (x2 =15.434,P<0.001).Conclusion RVS combined with CEUS guidance can improve the accurate position rate and early inactivation rate of RFA therapy for neonatal or recurrent lesions of HCC.

15.
Article in Chinese | WPRIM | ID: wpr-703163

ABSTRACT

Objective To explore the effects of aripiprazole on clinical symptoms and neurotrophic factor levels in patients with schizophrenia. Methods Forty patients with schizophrenia and 40 normal controls were included in the study. The clinical symptoms of patients receiving aripiprazole only for 12 weeks were evaluated by using the Positive and Negative Syndrome Scale (PANSS). Stroop Color-Word Test (SCWT), Continuous Performance Test, Digit-Symbol Coding Test and Trail Making Test-A were used to evaluate the cognitive function both in patients and controls. Serum levels of Nerve Growth Factor (NGF), Brain Derived Neurotrophic Factor (BDNF) and Neurotrophin 3 (NT-3) were measured using enzyme linked immunosorbent assay. Results The clinical scores, cognitive function and levels of neurotrophic factors were different before and after treatment (P<0.01). And those were significantly lower in patients than in control group (P<0.05). Before treatment, BDNF was negatively correlated with PANSS negative symptom score (r=-0.362, P=0.022);NGF was related to the total score of PANSS (r=0.332, P=0.037) and positive symptoms (r=0.401, P=0.010); NT-3 was associated with negative symptom scores (r=-0.376, P=0.017) and SCWT-color words (r=0.332, P=0.037) in patient group. After treatment, the increase in BDNF was correlated with the reduction in PANSS total score (r=0.371, P=0.018), negative symptom score (r=0.345, P=0.029) and general pathology score (r=0.342, P=0.031). There was a correlation of the increase of NGF with the decrease of PANSS total scores (r=0.437, P=0.005) and with positive symptom scores (r=0.357, P=0.024). Conclusion Treatment with Aripiprazole can improve the clinical symptoms and cognitive functiona impairments in patients with schizophrenia, which may be related to the increase in serum levels of BDNF, NGF and NT-3.

16.
Article in Chinese | WPRIM | ID: wpr-702357

ABSTRACT

Objective To investigate the incidence and risk factors of liver abscess after radiofrequency ablation (RFA) for liver cancer.Methods A retrospective study was performed on 1 643 patients from January 2000 to June 2016.All the patients were diagnosed with hepatocellular carcinoma (HCC,n =942),cholangiocellular carcinoma (CCC,n =31) or metastatic liver carcinoma (MLC,n=670).Univariate and multiple Logistic regression analysis were used to evaluate the risk factors of liver abscess.Results The incidence of liver abscess after RFA was 0.79%% (13/1 643).Univariate analysis indicated that the liver abscess was significantly correlated with the history of diabetic mellitus (DM),Child-Pugh level,history of surgery and tumor location (all P<0.05).Multivariate analysis showed that the history of DM,history of surgery and tumor location were independent risk factors of liver abscess after RFA for liver cancer.Conclusion History of DM,surgery and tumor location are important factors that result in liver abscess after RFA.

17.
Article in Chinese | WPRIM | ID: wpr-702355

ABSTRACT

Objective To investigate the application value of ultrasound-guided percutaneous radiofrequency ablation (RFA) in treatment of liver metastases of malignant tumor.Methods Clinical and imaging data of 109 patients with liver metastases of malignant tumor who underwent ultrasound-guided percutaneous RFA during December 2009 to May 2015 were retrospectively analyzed.Results There were 31 patients (31/109,28.44%) with single liver metastases and 78 patients (78/109,71.56%) with multiple lesions.The primary tumors included colorectal,lung,breast,gastric,pancreatic,ovarian and prostate carcinomas.Among all 198 liver metastases,there were 151 (151/198,76.26%) with diameter < 3 cm and 47 (47/198,23.74%) with diameter ≥3 cm.One month after RFA,187 lesions (187/198,94.44%) were completely inactivated,while the other 11 lesions (11/198,5.56%) still had residual activity.One month later,the tumor markers improved obviously compared with those before treatment (all P<0.05).The incidence of intraoperative and postoperative complications was 6.42% (7/109).Conclusion Ultrasound-guided percutaneous RFA is a safe and effective treatment for patients with non-surgical indications of malignant liver metastases,which can partially control the survival activity of liver metastases.

18.
Article in Chinese | WPRIM | ID: wpr-702354

ABSTRACT

Objective To investigate the efficacy and prognostic factors of percutaneous ultrasound-guided radiofrequency ablation (RFA) for liver metastases from gastric cancer.Methods Clinical and imaging data of 55 patients with liver metastasis from gastric cancer who underwent percutenous ultrasound-guided RFA were retrospectively analyzed,and the overall survival rates and prognostic factors were assessed.Results The overall survival rates of 1-,2-,3-and 5-year was 70.45%,42.90%,20.32% and 10.16%,respectively.The ablation rate was 94.12% (96/102) 1 month after RFA,and the local recurrent rate was 15.69% (16/102),the new metastasis rate was 52.73% (29/55).Age (P=0.015),tumor number (P=0.011),extrahepatic metastasis before RFA (P=0.026) and chemotherapy after RFA (P=0.031) were significantly prognostic factors.Age (P=0.033),tumor number (P=0.004) as well as chemotherapy after RFA (P=0.001) were independent prognostic factors.The severe complication rate was 1.82% (1/55),while no treatment-related death occurred.Conclusion Percutaneous ultrasound-guided RFA is a safe and effective therapeutic option for liver metastases from gastric cancer.Age,tumor number,chemotherapy after RFA are independent prognostic factors.

19.
Article in Chinese | WPRIM | ID: wpr-702352

ABSTRACT

Objective To investigate the value of percutaneous radiofrequency ablation (RFA) in the treatment of large hepatic carcinoma adjacent to diaphragm.Methods Totally 176 patients with larger hepatic carcinoma adjacent to diaphragm (adjacent diaphragm group) and 157 patients with larger hepatic carcinoma not adjacent to the diaphragm (control group) underwent ultrasound-guided percutaneous RFA treatment,and the data of these patients were retrospectively analyzed.The patients,age,gender,the largest diameter of lesions,ablation information,early necrosis rate,recurrence rate,new tumor rate and survival rate were analyzed and compared between the two groups.Results Cases of injection physiological saline below the diaphragm during RFA were significantly higher in adjacent diaphragm group than that in control group (P=0.016).The recurrence rate of adjacent diaphragm group was significantly higher than that of control group (P=0.028).There was no significant difference of patients,age,gender,the largest diameter of lesion,RFA instrument,RFA needles,early necrosis rate,new tumor rate,nor complications rate between the two groups (all P>0.05).There was no significant difference of the 1-,2-,3-,4-and 5-year survival rate between the two groups (P=0.203).Conclusion Large hepatic carcinoma adjacent to diaphragm is more likely to recur after ultrasound-guided percutaneous RFA.The method of injection physiological saline below diaphragm and other individualized treatment plan and strategy should be used during RFA treatment.

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Chinese Journal of Ultrasonography ; (12): 1054-1057, 2018.
Article in Chinese | WPRIM | ID: wpr-734219

ABSTRACT

Objective To study the enhanced performance of contrast-enhanced ultrasouond( CEUS) parametric imaging , and to explore the diagnostic value of CEUS parametric imaging in predicting extracapsular invasion and cervical lymph node metastasis of papillary thyroid cancer( PTC) . Methods One hundred and fifty-eight PTCs in 136 patients pathologically proven papillary thyroid carcinoma between January 2016 and January 2017 were enrolled in this study . According to the pathological results of extracapsular invasion and cervical lymph node metastasis respectively ,the PTCs were grouped into the negative group and the positive group . The parametric imaging features of the two groups were summarized to explore the risk factors of extracapsular invasion and cervical lymph node metastasis of PTCs respectively . Results The parametric imaging suggested that centripetal enhancement had a significant effect on extracapsular invasion ( P =0 .001) . While there was no difference in the perfusion start time of extracapsular invasion between the negative and positive group ( P > 0 .05 ) . Besides , there was no statistical significance in the perfusion start time and perfusion pattern of cervical lymph node metastasis between the negative and positive group (all P >0 .05) .Conclusions The parametric imaging features help predicting extracapsular invasion in PTCs . And the ones with centripetal enhancement patterns are more often with extracapsular invasion .

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