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Objective:To investigate the clinical and imaging characteristics of liver density changes in patients with initial-treated drug-sensitive secondary tuberculosis during standardized treatment and after withdrawal when cured.Methods:A retrospective analysis was conducted of 34 patients with initial-treated drug sensitive pulmonary tuberculosis in Beijing Chest Hospital of Capital Medical University and the First Affiliated Hospital of Xinxiang Medical University from January 2014 to April 2019. The chest computed tomography (CT) examination and sputum culture were performed before treatment. The patients received the standardized treatment and they were divided into three groups according to the course of treatment (three, nine and 12 months). Liver density and liver function were followed up during treatment (three, six, nine and 12 months) and after drug withdrawal (3, 6 and 12 months). The measurement data were analyzed by t-test. Results:The average liver density of these three groups gradually decreased during the treatment period, and gradually increased after drug withdrawal. There were five and nine cases of fatty liver occurred at three and six months of treatment in the six-month treatment group, respectively; and six, two and zero cases of fatty liver occurred at three, six, and 12 months after drug withdrawal, respectively. There were four, eight and 11 cases of fatty liver occurred at three, six, and nine months of treatment in the nine-month treatment group, respectively; and seven, two and zero cases occurred at three, six, and 12 months after drug withdrawal, respectively.There were five, 10, 14 and 14 cases of fatty liver occurred at three, six, nine and 12 months of treatment in the 12-month treatment group, respectively; and 12, 10 and five cases occurred at three, six, and 12 months after drug withdrawal, respectively. During the course of treatment, the density of livers of some cases decreased unevenly, and the density of right lobe of the liver was lower than the left lobe. The density of left lobe of the liver was (49.8±4.0) HU, (45.0±3.9) HU, (37.0±9.9) HU, (45.3±8.1) HU, (48.4±6.6) HU at the treatment of six, nine and 12 months and drug withdrawal of three and six months, and the density of right lobe of the liver was (44.0±6.1) HU, (37.2±7.7) HU, (25.5±15.8) HU, (38.5±11.7) HU, (43.8±9.9) HU, the differences were statistically significant ( t=4.611, 4.512, 2.307, 2.803 and 2.291, respectively, all P<0.05), while those were not statistically significant among three months of treatment and 12 months after drug withdrawal ( t=1.573 and 1.199, respectively, both P>0.05). There were two cases showed alanine aminotransferase (ALT) and aspartate amiotransferase (AST) accompanied elevated (ALT>2×upper limits of normal (ULN), AST<2×ULN) at three and six months of treatment, with no abnormalities detected of alkaline phosphatase (ALP) and total bilirubin (TBil). Conclusions:The liver density gradually decreases and uneven fatty liver could appear during anti-tuberculosis treatment, but it gradually returns to normal or relieves after drug withdrawal. The degree of fatty liver is not synchronized with the changes of liver function indexes (ALT, AST, ALP and TBil), which belongs to chronic reversible injury.
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Objective To study the method and therapeutic effect of microsurgical treatment by unilateral subfrontal approach in patients with large olfactory groove meningiomas. Methods The clinical data of 16 patients with large olfactory groove meningiomas who had underwent microsurgical treatment by unilateral subfrontal approach from January 2010 to December 2017 were analyzed retrospectively. Results Total removal of tumor (Simpson Ⅰ and Ⅱ grade) was achieved in 14 cases and subtotal removal of the tumor (Simpson Ⅲ) was in 2 cases. No patient died from the microsurgery. The treatment effect was satisfactory in all patients during the follow- up. Conclusions The microsurgical treatment by unilateral subfrontal approach in patients with large olfactory groove meningiomas conforms to the concept of minimal invasive surgery, which provides enough surgical space, and the effect of surgery is satisfactory. So the approach is a good choice for the removal of large olfactory groove meningiomas.
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Objective To investigate the correlation between tumor perfusion parameters and tumor volume and Child-Pugh classification in CT of hepatocellular carcinoma (HCC).Methods Fifty-six patients with hepatocellular carcinoma were selected to perform CT perfusion imaging.The parameters of the total tumor perfusion such as hepatic artery perfusion (HAP),portal vein perfusion (PVP)and hepatic perfusion index (HAPI)were calculated according to the degree of hepatic encephalopathy,albumin,bilirubin, clotting time,ascites for liver Child-Pugh classification.The relationship between the tumor or peritumoral perfusion parameters with tumor volume and Child-Pugh classification were analyzed.Results (1)There was no correlation between tumor or peritumoral perfusion with the tumor volume.(2)The difference of HAP,PVP and HAPI between the different Child-Pugh classification groups was statistically significant (P<0.000 1).(3)With the reduction of Child-Pugh classification,the tumor body HAP and HAPI values gradually decreased, while the PVP value increased gradually.Conclusion There is no correlation between the tumor volume of hepatocellular carcinoma with total tumor perfusion parameters.The differences in perfusion measurements between different Child-Pugh classification can intuitively and quantitatively reflect the reserve function of the liver.
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Objective To study the pulmonary protective effect of large dose of ambroxol hydrochloride injection in postoperative patients with severe hypertensive intracerebral hemorrhage.Methods One hundred and sixty postoperative patients with hypertensive intracerebral hemorrhage were selected,and the patients were divided into conventional dose group and large dose group by random digits table method with 80 cases each.The therapeutic effect,partial pressure of oxygen,oxygenation index,acute physiology and chronic health evaluation Ⅱ score,antibiotic application time and hospitalization period in intensive care unit were compared between 2 groups.Results After treatment,the partial pressure of oxygen and oxygenation index in large dose group were significantly better than those in conventional dose group:(94.7 ± 7.2) mmHg (1 mmHg =0.133 kPa) vs.(86.5 ± 8.1) mmHg and (420.3 ± 35.5) mmHg vs.(356.0 ± 28.7) mmHg,the acute physiology and chronic health evaluation Ⅱ score was significantly lower than that in conventional dose group:(8.2 ± 3.4) scores vs.(11.6 ± 3.5) scores,the antibiotic application time and hospitalization period in intensive care unit were significantly shorter than those in conventional dose group:(8.5 ± 3.7) d vs.(13.4 ± 5.8) d and (7.3 ± 2.5) d vs.(9.7 ± 5.2) d,and there were statistical differences (P＜ 0.05).The total effective rate in large dose group was significantly higher than that in conventional dose group:92.5％ (74/80) vs.83.8％ (67/80),and there was statistical difference (P ＜ 0.05).Conclusion The pulmonary protective effect of large dose of ambroxol hydrochloride injection is significant in postoperative patients with hypertensive intracerebral hemorrhage.
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One case of traumatic carotid-cavernous fistula (TCCF) with small fistula treated by transarterial detachable coil embolization was reported. The intermittent ipsilateral carotid compression was used to identify the final blocking of the residual fistula. The follow-up digital subtraction angiography showed that the TCCF was cured finally. From this case, we conclude that this method may be an effective way to treat TCCF with small fistula.