The value of DWI in the differential diagnosis between chordoma and chondrosarcoma in skull base / 实用放射学杂志

Objective To explore the application value of diffusion-weighted imaging(DWI) in distinction of skull base chordoma from chondrosarcoma.Methods The clinical data and imaging findings of basicranial tumor confirmed by pathology,including 14 patients with classic chordoma,9 with poorly differentiated chordoma and 18 with chondrosarcoma were analyzed retrospectively.The lesion location,enhancement patterns,signal intensity on T2 WI relative to gray matter,and apparent diffusion coefficient (ADC) values were reviewed.The enhancement pattern was scored as 0 (little or non-enhancement),1 (heterogeneous enhancement),or 2 (homogeneous enhancement in ≥90％area).The data were analysed by Kruskal-Wallis test.Results There were significant differences in the mean,minimum and maximum ADC values,the intensity on T2 WI and the enhancement pattern among the three tumor types (P ＜0.05).However,the differences in the score of enhancement pattern and lesion location were not found (P＞0.05).Conclusion DWI may be helpful for the diagnosis of skull base chordoma from chondrosarcoma,and the accuracy rate will be improved when combined with T2WI intensity.

Impact of fatty liver on antiviral effect in chronic hepatitis B / 重庆医学

Objective To investigate the impact of fatty liver on antiviral effect in the patients with chronic hepatitis B (CHB) .Methods A total of 204 patients with hepatitis Be antigen (HBeAg ) positive CHB in the outpatient department of our hospital from January 2011 to April 2014 were selected as the research subjects and divided into the two groups according to wheth‐er complicating fatty liver :the simple CHB group(control group ,122 cases) and CHB complicating nonalcoholic fatty liver disease (NAFID) group(observation group ,82 cases) .The two groups all received the 24‐week antiviral therapy of adefovir (10 mg/d) . The differences in the normalization rate of ALT/AST (biochemical response) ,HBeAg negative conversion rate (serological re‐sponse) and HBV DNA negative conversion rate(virological response) were compared between the two groups .Then the cases ob‐taining the virological response after treatment in the two groups were compared again .Among the cases obtaining virological re‐sponse,thedifferencesinthenormalizationrateofALT/AST(biochemicalresponse)andHBeAgnegativeconversionrate(serologi‐cal response) were compared between the simple CHB group and CHB complicating NAFID group .Results The normalization rate of ALT/AST after 24‐week treatment in the CHB complicating NAFID group was 58 .5% ,which was significantly lower than 72 .1% in the simple CHB group ,the difference was statistically significant ;the negative conversion rate of HBV DNA and HBeAg after 24‐week treatment in the simple CHB group was 67 .2% and 52 .5% ,which were significantly higher than 51 .2% and 37 .8%respectively ,the differences were statistically significant ;among the cases obtaining the virological response ,the normalization rate of ALT/AST in the simple CHB group was 96 .3% ,which was significantly higher than 66 .7% in the CHB complicating NAFID group ,the difference was statistically significant .But among the cases obtaining the virological response ,the negative conversion rate of HBeAg was 78 .0% in the simple CHB group and 73 .8% in the CHB complicating NAFID group ,the simple CHB group was slightly higher than the CHB complicating NAFID group without statistical difference .Conclusion NAFLD has impact on the antiviral effect of adefovir treatment in CHB patients with positive HBeAg ,whereas complicating NAFLD is an important reason for reaching the virological response and serological response ,but without reaching the biochemical response in the antiviral treatment of CHB complicating NAFID .

Comparison of efficacy of induction chemotherapy plus intensi-ty-modulated radiotherapy and concurrent chemo-radiotherapy plus adjuvant chemotherapy for patients with loco-regionally ad-vanced nasopharyngeal carcinoma / 中国肿瘤临床

Objective: To compare the efficacy of induction chemotherapy (IC) plus intensity-modulated radiotherapy (IMRT) with that of concurrent chemo-radiotherapy (CCRT) plus adjuvant chemotherapy (AC) for patients with loco-regionally advanced naso-pharyngeal carcinoma (NPC). Methods:Data of 240 patients with loco-regionally advanced NPC were reviewed. These patients were admitted to the Sun Yat-sen University Cancer Center between January 2004 and December 2008. Among the 240 patients, 117 under-went the IC+IMRT and 123 were treated with the CCRT+AC. The IC+IMRT group received a regimen including cisplatin and 5-fluoro-uracil (5-FU). The CCRT+AC group received cisplatin concurrently with radiotherapy and subsequently received adjuvant cisplatin and 5-FU. The survival rates of the patients were assessed by Kaplan-Meier analysis, and the survival curves were compared by Log-rank test. Multivariate analysis was conducted using Cox proportional hazard regression model. Results:The 5-year overall survival (OS), disease-free survival, distant metastasis-free survival, local relapse-free survival, and the nodal relapse-free survival were 78.0%versus 78.7%, 68.9%versus 67.5%, 79.0%versus 77.0%, 91.6%versus 91.0%, and 95.3%versus 93.7%in the IC+IMRT and CCRT+AC groups, respectively. The survival between the two groups exhibited no significant differences. Higher rates of Grades 3 to 4 nau-sea-vomiting (8.1%vs. 1.7%, P=0.023) and leukopenia (9.7%vs. 0.9%, P=0.006) were observed in the CCRT+AC group. Multivariate analysis revealed that N stage and age were significant prognostic factors for the OS of the patients with loco-regionally advanced NPC. Conclusion:The treatment outcomes of IC+IMRT and CCRT+AC were similar. Distant metastasis remained as the predominant mode of treatment failure.

Clinical efficacy of repair for defect after xanthelasma removal with a subcutaneous pedicle flap based on the orbicularis oculi muscle / 中华医学美学美容杂志

Objective To study the method and effect of subcutaneous pedicle flap based on the orbicularis oculi muscle in the treatment of xanthelasma.Methods According to the situation of xanthelasma and the soft tissues of upper eyelid,two new double-folds eyelid was designed.The soft tissues (including the skin and muscle) between two lines were intended to form a subcutaneous pedicle flap based on the orbicularis oculi muscle.Then,after the excision of xanthelasma from the surface of orbicularis oculi muscle,the flap was transferred to the defected site.Finally,a new double-folds eyelid was made.Results 13 cases with 25 sides were treated with a follow-up period of 3-6 months.All flaps were survived with good functions and the appearance of upper eyelids were satisfactory.Conclusions Subcutaneous pedicle flap based on the orbicularis oculi muscle is a reliable option for the treatment of xanthelasma.It has the advantages of abundant blood supply,convenience and effective.

Expression and clinical significance of serum IL-2 and TNF-αin patients with pulmonary tuberculosis combine diabetes / 重庆医学

Objective To investigate the expression of serum interleukin-2(IL-2),tumor necrosis factor-α(TNF-α)in the pa-tients with pulmonary tuberculosis and diabetes,and prelininary explore its clinical significance.Methods Experiment were divided into control group(health check-up outpatient,n=10),pulmonary tuberculosis group(n=20),diabetes group(n=20),tuberculosis combine diabetes group(n=20),tuberculosis combine diabetes group was divided into improved group,diabetes group and deterio-rated group after 2 months with therapy according to disease outcome,ELISA assay was used to measured the level of serum IL-2 and TNF-α.Results Before treatment:serum IL-2 levels of pulmonary tuberculosis group,diabetes group and pulmonary tuberculo-sis combine diabetes group were reduced (P0.05).Conclusion IL-2 and TNF-αplay a role in the immune pathogenesis of tuberculosis combine diabetes,which dynamic changes can reflect the progression and outcome of pulmonary tuberculosis combine diabetes.