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Objective:To study the features of adenomyomatous hyperplasia (AH) of the Vaterian system (common bile duct and ampulla of Vater) to help in the diagnosis and management of this disease.Methods:A retrospective analysis on the data of 17 patients who had a postoperative pathological diagnosis of AH of the Vaterian system treated from January 2005 to December 2021 at the First Medical Center of the PLA General Hospital was carried out with 12 males and 5 females, aged (58.4±11.3) years. The clinical presentations, treatment and postoperative pathology of these patients were analyzed. Patients with dysplasia of the tubular mucosal epithelium in the non-cancerous area around the AH under microscopy were included in the AH with dysplasia group ( n=8), and those without dysplasia were included in the control group ( n=9). The clinical characteristics of the two groups were compared. Results:The main clinical symptoms were abdominal pain in 8 patients, jaundice in 7 patients and fever in 2 patients. Preoperative imaging showed 10 cases of occupying lesions and 6 cases of abnormally dilated intrahepatic and extrahepatic bile ducts without obvious lesions or stones or biliary tract injury stenosis. Sixteen patients underwent radical pancreaticoduodenectomy, and 1 patient underwent extrahepatic biliary resection combined with choledochojejunostomy for bile duct obstruction due to biliary stones, 3 patients had combined malignant tumors, 1 patient had a carcinoma of AH origin at the ampulla of Vater, and the other 2 patients had neoplastic lesions in the mucosal epithelium adjacent to the AH (cholangiocarcinoma and ampullary carcinoma, respectively). There were no significant differences in age, gender, bile duct stones, cholangitis, combined carcinoma and liver function indexes between the two groups of patients with AH of the Vaterian system (all P>0.05). Conclusion:Adenomyomatous hyperplasia of the Vaterian system was difficult to distinguish preoperatively from malignant tumors basing on its clinical presentations or imaging findings. Such patients are recommended to be treated surgically.
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Objective To study and analyze the short-term effect of glucocorticoid in patients with idiopathic interstitial pneumonia by analyzing the semi quantitative scores of high resolution CT.Methods 50 cases of idiopathic interstitial pneumonia treated in our hospital from May 2015 to October 2016 were selected as the research object.Clinical data were analyzed, including smoking, signs of hospitalization and dyspnea score.High resolution CT level for the right diaphragmatic top tube, bifurcation, left atrium roof, in 3 aspects from the calculation of cellular disease and shadow grid as a percentage of average, the critical point of high resolution CT scores were 10%, 20%, 30%, 40% and 50%.The accuracy, sensitivity and specificity of glucocorticoids were analyzed.The chi square test was used to examine the enumeration data.Results The accuracy was 72% when the high resolution CT score was 20% critical point.In patients treated with corticosteroids, the high resolution CT score was greater than or equal to 20% for patients and 25 for patients with a score of less than 20% for 25 patients.20% or more patients died during hospitalization, 10 cases, the mortality rate was 40%, and the effective rate of glucocorticoid treatment was 8%.Less than 20% of the patients died during hospitalization, 1 cases, the mortality rate was 4%, and the effective rate of glucocorticoid treatment was 50%.Conclusion High resolution CT semi quantitative score judgment of idiopathic interstitial pneumonia patients treated with glucocorticoid efficacy of high accuracy, high resolution 20% scores higher accuracy, and the diagnosis is well, with further clinical promotion and application significance.
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Objective To investigate and analyze the efficacy of CT guided percutaneous cisplatin cisplatin implantation in the treatment of non-small cell lung cancer.Methods 80 cases of non small cell lung cancer patients in our hospital from January 2015 to March 2016 were randomly divided into the control group and the experimental group, each group of 40 patients.The control group was treated with cisplatin and cisplatin, and the patients in the experimental group were treated with CT guided percutaneous cisplatin sustained-release implantation.The clinical standards of the experimental group and the control group were compared and analyzed.Results After treatment, the number of invalid cases in the experimental group was 8 cases, the effective number was 32 cases, the effective rate was 80%.The number of invalid cases in the control group was 32 cases, and the effective number was 8 cases.The effective rate of the patients in the experimental group was significantly higher than that in the control group (P<0.05).The 1-year survival rate of the experimental group was 77.5%, significantly higher than that of the control group, and the survival rate was 60%, with statistical difference (P<0.05).The incidence of adverse reactions in the experimental group (37.5%) was significantly lower than that in the control group (17.5%), with statistical difference (P<0.05).Conclusion CT guided percutaneous treatment of percutaneous intratumoral implantation of slow-release cisplatin in treatment of non-small cell lung cancer can improve the treatment efficiency in a certain degree, high security, with the further promotion and application significance.