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<p><b>OBJECTIVE</b>To investigate the value of MRI follow-up in pediatric patients with spinal tuberculosis.</p><p><b>METHODS</b>From February 2004 to April 2013, MRI imaging data in 21 children with spinal tuberculosis by pathologically and clinically proven were retrospectively analysed. There were 11 males and 10 males, with an average age of 9.4 years old ranging from 2 to 14 years old. Eighteen patients were received conservative treatment, 3 patients were treated by surgical operation. The course of disease ranged from 2 months to 3 years. All cases underwent two or more MRI examinations for follow-up. MRI findings of the first and second examination were comparatively analyzed,including signal changes of vertebral body and intervertebral, paraspinal abscess and the change of kyphosis angle.</p><p><b>RESULTS</b>In the 21 cases with tuberculosis, 85 vertebral bodies were affected in total, including 10.6%(9/85), 49.4%(42/85) and 40%(34/85) vertebral bodies separately in the cervical,thoracic, lumbosacral spine. Follow-up MRI showed vertebral body shape and signal had no obvious change during or after treatment, 15 cases with vertebral bodies changed flat or cuneate, 10 cases with disc involvement,and intervertebral space became narrowing at different level. Among 13 patients with kyphosis angle greater than 0°, 7 were located on thoracic, 2, 3, 1 were on thoracolumbar, lumbar and cervical spine, respectively. Among 18 cases with conservative treatment,kyphosis angle were 0° on the first and the follow up MRI of 8 patients. One case of mild (<10°) kyphosis,follow-up MRI during therapy showed the angle slightly increased; 5 cases with moderate (10° to 30°), follow-up MRI during therapy showed no obvious change; 4 cases with severe (>30°), follow-up MRI during and after therapy showed kyphosis increased in varying degrees.</p><p><b>CONCLUSION</b>Follow-up MRI can make a big difference in the spinal tuberculosis of children; it can clearly show the change of the vertebral body and intervertebral space, paraspinal abscess and the kyphosis angle after the treatment,which can provide reference for clinical treatment and estimating prognosis.</p>
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Adolescent , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Mâle , Antibactériens , Utilisations thérapeutiques , Surveillance des médicaments , Études de suivi , Imagerie par résonance magnétique , Radiographie , Études rétrospectives , Rachis , Imagerie diagnostique , Tuberculose vertébrale , Imagerie diagnostique , Traitement médicamenteux , Chirurgie généraleRésumé
<p><b>OBJECTIVE</b>To explore the effect of compound qizhu granule (CQG) on cellular immunity of chronic hepatitis B (CHB) patients.</p><p><b>METHODS</b>Totally 103 CHB patients treated with lamivudin (LAM) for 6 months, who had partial virological response (HBeAg positive) were randomly assigned to two groups, 50 in the treatment group and 53 in the control group. All patients took LAM 100 mg (once a day) plus ADV 10 mg (once a day). Patients in the treatment group additionally took CQG, one dose per day. After one-year treatment hepatitis B virus (HBV) DNA negative rates, HBeAg seroconversion, levels of HBV specific cytotoxic T lymphocyte (CTL), non-specific CTL and natural killing (NK) cells were compared between the two groups.</p><p><b>RESULTS</b>After 1-year treatment, HBV DNA negative rate of the treatment group was 88: 0% in 44 cases, slightly higher than that of the control group (41 cases, 77.4%), but with no statistical difference (P >0.05). HBeAg seroconversion of the treatment group was 32.0% in 16 cases, higher than that of the control group (8 cases, 15.1%), with statistical difference (P <0.05). Levels of HBV specific CTL (0.79%±0. 07%), non-specific CTL (19.4%±1.8%) and NK cells (14. 1%± 1.5%) of the treatment group were higher than those of the control group (0.58% ± 0.08%, 17.5% ± 1.7%, and 11.1%±1.5%, respectively; allP <0.01).</p><p><b>CONCLUSION</b>Treating CHB patients with partial virological response by ADV plus CQG could improve specific and non-specific cellular immunity, thereby elevating HBeAg seroconversion rate.</p>
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Humains , Médicaments issus de plantes chinoises , Utilisations thérapeutiques , Antigènes e du virus de l'hépatite virale B , Allergie et immunologie , Virus de l'hépatite B , Génétique , Hépatite B chronique , Traitement médicamenteux , Allergie et immunologie , Immunité cellulaire , Allergie et immunologie , Lymphocytes T cytotoxiquesRésumé
<p><b>OBJECTIVE</b>To distinguish trochlear calcification and intraorbital foreign body after eye injury in order to avoid misdiagnosis as well as mistreatment.</p><p><b>METHODS</b>The orbital CT images of 403 patients, who visited the Eye Hospital or the Second Affiliated Hospital of Wenzhou Medical College during May 2005-April 2007, were reviewed. The diagnosis of trochlear calcification and intraorbital foreign body was made together by a skilled radiologist as well as an ophthalmologist. General information and CT characteristics in the patients with trochlear calcification were collected.</p><p><b>RESULTS</b>Using CT scan images, 27 among 403 patients (6.69%) were identified with trochlear calcification. Three patients (3/27, 11.11%) were misdiagnosed by radiologists as intraorbital foreign body. Among the 27 patients with trochlear calcification, 23 (85.19%) were male and 4 (14.81%) were female, with an unilateral calcification in 7 patients (7/27, 25.93%) and bilateral in 20 (74.07%) . The highest occurrence of trochlear calcification was in 31-40 years old group (13/403, 3.23%) which reached to 12.87% (13/101) after age-correction. There were 3 types of trochlear calcification on the basis of CT images: commas, dot and inverted "U".</p><p><b>CONCLUSIONS</b>The trochlear calcification is not an uncommon phenomenon and should not be diagnosed as intraorbital foreign body, especially when it co-exists with eye injury in 31-40 years old group. Injury history and our classification method on the basis of CT images could help to avoid misdiagnosis.</p>
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Adolescent , Adulte , Sujet âgé , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Nourrisson , Nouveau-né , Mâle , Adulte d'âge moyen , Calcinose , Imagerie diagnostique , Corps étrangers oculaires , Imagerie diagnostique , Lésions traumatiques de l'oeil , Imagerie diagnostique , Orbite , Imagerie diagnostique , Maladies de l'orbite , Imagerie diagnostique , TomodensitométrieRésumé
Objective To investigate the clinical significance of a new method,axis-line-distance technique(ALDT),in scoliosis measurement.Methods Thirty cases with idiopathic scoliosis were measured on two separate occasions by six observers with the Cobb technique and the ALDT on PACS workstation.The interval time between two measurement occasions were three weeks.The data were analyzed statistically with the paired-sample t-test.Results(1)Concerning intraobserver variance in two measurement occasions,the minimum variance,the maximum variance and the average variance were 0, 24.00?,5.71??1.54?for Cobb technique and 0,12.00 mm,(1.95?0.58)mm for ALDT.There were significant measurement differences for four observers with Cobb method 39.00??10.69?versus 36.50?? 10.63?,31.73??10.96?versus 37.30??9.65?,32.03??7.49?versus 27.86??9.00?,29.77??8.87? versus 34.20??7.26?,all P0.05].(2)Concerning interobserver variances in six observers,the average measurement variance was 5.07??0.35?for Cobb method,and(2.32?0.26)mm for ALDT. There were significant measurement differences for every observer using with Cobb method(36.63??10.30? versus 33.27??10.10?,39.00?10.69?versus 31.73??10.96?,32.03??7.49~ versus 29.78?? 8.87?,36.63??10.30?versus 39.00??10.69?versus 32.03??7.48?,39.00??10.69?versus 32.03?? 7.49?,all P
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Objective To describe the skeletal CT imaging manifestations in patients with tuberous sclerosis complex(TSC),and to analyze their diagnostic value so as to establish an adequate skeletal change imaging data for the diagnosis of TSC.Methods Thirteen patients fulfilling TSC diagnostic criteria were examined with CT of the brain (n=13)and abdomen (n=7).Examinations from January,2004 to July, 2006 were retrospectively analyzed.Results There were three forms of lesions being demonstrated on CT: (1)Multiple sclerosing nodule (n=13):numerous,ovoid and circular,homogeneous,small and well- defined loci and symmetrical lesions were revealed in all cases in the central marrow portion of the bones, which could mimic blastic metastases.Follow-up CT imaging showed no change in both size and number. The lesions measured approximately 2-10mm.(2)Local sclerosing bone dysplasia with little bone expansion (n=7).Symmetrical and irregular density in the radix of the posterior arch of the vertebral body (n = 5 ).(3 )The spherical periosteal proliferation demonstrating as a cortex double line sign (n=2 ),and cortical thickening of metatarsals (n = 3 ).The appearance of the skeletal manifestation was as that in adulthood.Conclusion CT imaging of the skeletal system in TSC has some characteristics,by which the diagnosis of TSC could be made if combined with other main clinical diagnostic criteria. We suggest that those particular findings can be added as primary diagnostic features in the clinical diagnosis of TSC.
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Objective To study the conventional MRI and dittusion weighted imaging(DWI) features of Japanese encephalitis(JE)in children.Methods Sixteen patients with JE were included. Conventional MRI and DWI sequences were performed in all patients.Seven patients received MRI within 10 days of onset and 9 after 10 days.The appearances on DWI and T_2 WI were recorded.The ADC values of lesions were calculated,and then were correlated with the corresponding time interval between onset of neurological symptoms and MRI scanning.Results The lesions of JE mainly showed long T_1 and long T_2 signal intensity on MRI.The thalami were the most frequently involved areas,and 15 out of 16 showed thalamic involvement and 6 patients only showed thalamic abnormalities without other lesions.Seven patients within 10 days of onset showed lesions with high signal intensity on both DWI and T_2WI,but whole or partial lesions showed clearer on DWI than on T_2WI,and 2 patients showed extra lesions that were invisible on T_2WI.As for the other 9 patients after 10 days of onset,the lesions showed clearer on T_2WI than on DWI. There was a direct correlations between thalamic ADC values and the disease duration (r=0.84,P