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Objective:To evaluate the safety and preliminary efficacy of total neoadjuvant therapy (TNT) model of" neoadjuvant chemoradiotherapy plus consolidation neoadjuvant chemotherapy (CNCT) followed by surgery" for locally advanced gastric cancer.Methods:From 2018 to 2020, 28 patients clinically diagnosed with locally advanced gastric adenocarcinoma or Siewert Ⅱ/Ⅲ adenocarcinoma gastroesophageal junction cancer were prospectively enrolled. The neoadjuvant chemoradiotherapy (NCRT) was delivered with a total dose of 45 Gy, 1.8 Gy/f. Concurrent chemotherapy was S-1 at a dose of 40-60 mg twice daily. Then, patients received four to six cycles of CNCT of SOX regimen at three weeks after neoadjuvant chemoradiotherapy. D 2 lymphadenectomy was performed at 4-6 weeks after CNCT. Results:A total of 28 patients completed the whole therapy. Grade 3 or above adverse events occurred in 3 cases (11%) during CCRT, including thrombocytopenia, leukopenia and anorexia; 2 cases (7%) developed leukopenia and 3 cases (11%) of thrombocytopenia during CNCT. Twenty patients (71%) completed the surgery. The proportion of patients with pathological complete remission (pCR) was 50%. Three patients experienced surgical complications including anastomotic leak, anastomotic stenosis and intra-abdominal sepsis. All were recovered after symptomatic treatment.Conclusion:Interim analysis results demonstrate that TNT can yield significant down-staging for patients with locally advanced gastric cancer, which causes tolerable adverse events and postoperative complications.
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Objective:To evaluate the prognostic significance of neoadjuvant rectal (NAR) score and downstaging depth score (DDS) after neoadjuvant chemoradiotherapy (nCRT) for locally advanced rectal cancer (LARC).Methods:Retrospective analysis was performed for 200 patients with LARC (T 3-T 4 and/or N 1-N 2, M 0), who were initially treated in the Cancer Hospital of Chinese Academy of Medical Sciences from 2015 to 2018. All patients had baseline MRI data and received preoperative nCRT and radical resection. All patients received preoperative radiotherapy with a dose of 45-50Gy combined with concurrent capecitabine. The effect of NAR and DDS scores on clinical prognosis was statistically compared. The 3-year disease-free survival (DFS) was calculated using the Kaplan- Meier method and compared by the log- rank test. Cox proportional hazards model was used to perform multivariate survival analysis. The predictive performance for 3-year DFS was calculated using the receiver operating characteristic (ROC) curve. Results:The median follow-up time was 30.5(10.6-54.0) months. In terms of DDS, the 3-year DFS rate was 56.4% in the DDS ≤0 group, significantly lower than 83.0% in the DDS >0 group ( P=0.002). In terms of NAR score, the 3-year DFS rates were 90.1%, 73.8% and 53.6% in NAR score ≤8, 8-16 and>16 groups, respectively ( P<0.001). In the whole cohort, the area under the ROC curve (AUC) of DDS and NAR scores for predicting 3-year DFS were 0.683 and 0.756( P=0.037). In yp0-I stage patients ( n=72), the AUC of DDS and NAR scores for predicting 3-year DFS were 0.762 and 0.569( P=0.032). Conclusions:High DDS and low NAR scores after nCRT indicate good prognosis for patients with LARC. NAR score yields better accuracy than DDS in predicting clinical prognosis, but DDS is significantly better than NAR score in yp0-I stage population.
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Objective:To investigate the relationship between MRI parameters and clinical prognosis before and after chemoradiotherapy in patients with locally advanced rectal cancer.Methods:Clinical and follow-up data of 96 patients with locally advanced rectal cancer who were initially treated in the Cancer Hospital of Chinese Academy of Medical Sciences from 2015 to 2017 were retrospectively analyzed. All patients received preoperative chemoradiotherapy, followed by delayed radical surgery at 6-13 weeks after radiotherapy. MRI assessment was performed twice around radiotherapy which were within 4 weeks before the treatment and 4-8 weeks after it. Correlation analysis was utilized to determine the association between MRI assessment and 3-year disease-free survival (DFS).Results:Of the all patients, 80 (83%) had T 3 stage, 16(17%) had T 4 stage, 14 (15%) had N 0 stage, and 82 (86%) had N 1-2 stage. Among them, 69(72%) and 58(60%) patients were positive for MRF and EMVI. The median dose of radiotherapy was 50 Gy, and all patients were sensitized by simultaneous capecitabine. After chemoradiotherapy, T-downstage rate of the whole group was 24%, and 50% for the N-downstage rate. The MRF-and EMVI-positive rates were significantly decreased to 37% and 27% after chemoradiotherapy (both P<0.001). Univariate and multivariate analyses showed that N staging and EMVI status change were significantly correlated with the 3-year DFS. Conclusion:MRI after concurrent chemoradiotherapy reveals that positive EMVI throughout the treatment and N 1-N 2 staing are poor prognostic factors of DFS, suggesting the need for improving the treatment.
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Objective@#To investigate the predictive value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters for the efficacy of neoadjuvant chemotherapy in locally advanced gastric cancer.@*Methods@#Sixty-five patients with locally advanced gastric cancer (LAGC) confirmed by gastroscopy and received neoadjuvant chemotherapy (NCT) were enrolled in this study. Quantitative DCE-MRI was performed before NCT, and the quantitative parameters were measured, including volume transfer constant (Ktrans), rate constant (Kep), volume fraction of extravascular extracellular space (Ve) and volume fraction of plasma (Vp). After NCT, all patients received radical gastrectomy. According to postoperative pathological tumor regression grade, patients were divided into response group and non-response group, and the differences of DCE quantitative parameters between the two groups were compared. ROC curve was utilized to analyze the predictive efficacy of DCE quantitative parameters for NCT response of LAGC, and multivariate logistic regression analysis was performed to analyze the predictive efficacy of combined parameters.@*Results@#Thirty-seven patients were in response group and 28 patients were in non-response group. The pretreatment Ktrans in the response group were [0.216 min-1 (0.130 min-1, 0.252 min-1)], significantly higher than [0.091 min-1 (0.069 min-1, 0.146 min-1)] of non-response group (P<0.001), and Ve in the response group were [0.354(0.228, 0.463)], significantly higher than [0.200(0.177, 0.253)]of non-response group (P<0.001). ROC analysis showed the AUCS of Ktrans and Ve in predicting NCT efficacy were 0.881 and 0.756, respectively. Multiple logistic regression analysis showed that the combination of the two parameters could improve the AUC to 0.921, with the sensitivity and specificity of 86.5% and 89.3%, respectively.@*Conclusion@#DCE-MRI quantitative parameters could help to predict the NCT response of LAGC, and the combination of parameters could improve the predictive efficacy.
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Objective To explore the correlation between gait parameters at 14 days and knee function and quality of life at 3 months after total knee arthroplasty (TKA). Methods Eighteen patients who underwent TKA were analyzed by using three-dimensional gait analysis system to observe their gait parameters. Knee joint function and life quality of the patients at 3 months after TKA were evaluated with WOMAC (Western Ontario and McMaster Universities Arthritis Index) and SF-36 (short form 36-item health survey scores) assessment scale and their correlations were analyzed simultaneously. Results At 14 days after TKA, single support time (SST) and peak knee flexion at swing (PKF) of the operated side of the leg were significantly smaller than those of the healthy side of the leg. The knee flexion angle at mid-stance (MKF) and knee valgus angle at mid-stance (MKV) of the operated side of the leg were significantly larger than those of the healthy side of the leg. There was a moderate negative correlation between the spatiotemporal parameters of the operated side of the leg and the WOMAC score during gait, while a high correlation between the WOMAC score and peak knee flexion at swing (PKF), MKF and MKV. Except for the step length and forward velocity, the other gait parameters were significantly correlated with SF-36 life quality score. The single support time (SST) and PKF had a highly positive correlation, while the MKF and MKV had a moderate negative correlation with SF-36 life quality score. Conclusions The SST, MKF, MKV and PKF in postoperative early gait analysis (14 days) results can be used as the effective indicators to judge postoperative knee function and rehabilitation efficacy of life quality after TKA surgery.
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Objective@#To discuss the imaging findings and clinicopathological features of the intramural gastric metastasis (IGM) of esophageal squamous cell carcinoma.@*Methods@#The imaging findings of 11 patients with IGM confirmed by surgical pathology were reviewed retrospectively, and compared with clinicopathological features. Of the 11 cases, eight underwent upper gastrointestinal radiography, ten underwent contrast enhanced computed tomography (CT) scans and one underwent plain CT scanning.@*Results@#In all 11 cases, the primary cancer was located in the middle or lower thoracic esophagus, and nine of 11 had lymph nodes metastasis. All of the 11 tumors within the stomach were located in the upper one-third of the stomach, with the maximum diameter of tumor ranging from 1.0 cm to 12.0 cm. Gastrointestinal radiography showed irregular filling defect of the stomach in three cases with clear border resembled a submucosal tumor. Mucosal folds of the stomach were irregular and rough in two cases. On CT scans, nodule or mass in the gastric wall was found in seven patients, and two of them were accompanied with ulcer formation. Eccentric or nodular gastric wall thickening was found in the other two patients. All of them were heterogeneous mild-to-moderate enhancement.@*Conclusions@#The imaging appearances of IGM have certain characteristics, but final diagnosis depends on histopathology. The prognosis of IGM was extremely poor, so the preoperative diagnosis is very important to guide clinical treatment.
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Objective To analyze and summarize the imaging features of hepatic epithelioid hemangioendothelioma (EHE).Methods The retrospective and descriptive study was conducted.The clinicopathological data of 9 patients with EHE who were admitted to the Cancer Hospital of Chinese Academy of Medical Sciences between June 2012 and June 2016 were collected.Patients underwent computed tomography (CT) and magnetic resonance imaging (MRI) examinations.Number,size,location,shape,density or signal and enhancement method of lesions,with or without lesions fusion and relationship between lesions and vessels were analyzed by 2 imaging doctors.Lesions in left lobe of liver,right lobe of liver and caudate lobe of liver were respectively counted.Real number was a standard as less than 5 lesions and more than or equal to 5 lesions was represented as ≥ 5.Observation indicators:(1) overall imaging features of EHE;(2) MRI findings of EHE;(3) CT findings of EHE;(4) treatment and pathological features of EHE and results of follow-up.Patients received the corresponding treatment after imaging examinations.Follow-up using outpatient imaging examinations was performed to detect tumor recurrence and stable condition of patients up to December 2016.Results (1) Overall imaging features of EHE:of 9 patients with EHE,6 received plain and enhanced scans of MRI,3 received plain and enhanced scans of CT (1 combined with MRI),1 received enhanced scan of CT.Lesions in right lobe of liver were more than that in left lobe of liver,and there were fewest lesions in caudate lobe of liver.Lesions were round or similar-round shape,with a maximum diameter of 2.5-6.1 cm and an average diameter of 3.6 cm.Four patients had total 2-5 lesions and less than 5 lesions in each lobe of liver,without lesions fusion,including 1 with halo sign and capsule retraction sign and 1 with halo sign.Of other 5 patients,2 had more than or equal to 5 lesions in each lobe of liver and 3 had more than or equal to 5 lesions in 2 lobes of liver;4 had halo sign,lollipop sign,capsule retraction sign and a tendency of lesions fusion,1 had halo sign and capsule retraction sign.The halo sign,lollipop sign,capsule retraction sign and a tendency of lesions fusion were 7/9,4/9,6/9 and 4/9 in 9 patients,respectively.(2) MRI findings of EHE:6 patients received plain and enhanced scans of MRI.① Four patients had clearhalo sign on T2 weighted imaging (T2WI),in portal vein phase and hepatobiliary phase.Three patients had slightly central hyperintensity and thick ring of slightly peripheral hyperintensity on T2WI.There were slightly central hyperintensity and thin ring of slightly peripheral hypointensity in 1 patient,and the halo sign was seen by enhanced scan.There were central hyperintensity and peripheral hypointensity in 2 patients,and the halo signs were clearly seen in hepatobiliary phase.Some patients were combined with multiple manifestations.② There were no obvious halo sign on T2WI,annular enhancement in arterial phase by enhanced scan,no obvious halo sign in portal vein phase and hepatobiliary phase in 2 patients.There were hypointensity on T1WI and isointensity-hyperintensity on DWI in 6 patients.(3) CT findings of EHE:plain scan of CT in 4 patients showed slightly hypodense shadow,without calcification.Enhanced scan of CT in 3 patients showed that obvious halo-like enhancement was seen in portal vein phase and halo rings were less obvious than that by MRI examination.(4) Treatment and pathological features of EHE and results of follow-up:of 9 patients with EHE,4 underwent surgical resection based on lesions ≤5 and surgical specimens were detected by pathological examination,5 underwent interventional treatment and pathologic examination with biopsy.Gross specimen examination showed that lesions were solid and stiff,with greyish white section plane and infiltrative margin.Tumor cells consisted of epithelioid cells under the microscopy,without atypia and with rare mitotic figures,and vacuoles were seen in cytoplasm.Immunohistochemistry showed CD31 and CD34 were positive.Nine patients were followed up for 6-54 months.During the follow-up,4 patients with surgery had no recurrence and 5 patients with interventional therapy remained stable condition.Conclusions Imaging manifestations of hepatic EHE are the more typical when lesions of EHE became more.Hepatic EHE has a tendency of lesion fusion,halo sign,capsule retraction sign and lollipop sign.Imaging manifestations on T2WI with fat suppression,in portal vein phase and hepatobiliary phase are helpful to improve the diagnosis of hepatic EHE.
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Objective To understand the present situation and requirements of health education in schistosomiasis control in Hubei Province,so as to improve the health education to the targeted people. Method Through the questionnaire survey and field investigation,the data of the present situation and requirements of health education in schistosomiasis control were collect-ed in 24 counties(cities)of Hubei Province,and these data included the related institution structure of health education,basic information of personnel,equipment,funds,and health education working form. All the data collected were analyzed and evalu-ated. Results Among the 24 counties,there were 12 independent departments of health education,accounting for 50%. In terms of the basic information of the health education staff,the youngest person was 34 years old and the eldest was 58 years old,and the mean age was 46.55± 6.9 years. For the formal school education of the staff,5 had senior high school or below edu-cation (20.8%),16 had college education (66.7%),3 had bachelor degree or above (12.5%). There were 10 counties (41.70%)with the special funds for health education work but there were 3 counties(12.50%)without the special funds. Con-clusion The effectiveness of health education work in schistosomiasis control is remarkable,but there are still deficiencies in professional staff and funds in Hubei Province.
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Objective To investigate the pattern of nodal recurrence after curative resection in adenocarcinoma of the gastroesophageal junction ( AGE ) , and to provide a basis for delineation of the radiation range in the high-risk lymphatic drainage area.Methods A retrospective analysis was performed in 78 patients with locally advanced AGE who were newly treated in our hospital from January 2009 to December 2013 and had complete clinical data.All patients received curative resection and were pathologically diagnosed with stage T3/T4 or N (+) AGE.Those patients were also diagnosed with SiewertⅡor Ⅲ AGE by endoscopy, upper gastroenterography, macroscopic examination during operation, and pathological specimens.None of the patients received preoperative or postoperative radiotherapy.All patients were diagnosed by imaging with postoperative nodal recurrence.The computed tomography images of those patients were accessible and had all the recurrence sites clearly and fully displayed.Results The median time to recurrence was 10 months ( 1-48 months) , and 90%of the recurrence occurred within 2 years after surgery.The lymph nodes with the highest risk of recurrence were No.16b1( 39%) , No.16a2( 37%) , No.9 (30%), and No.11p (26%), respectively.There was no significant difference in the recurrence rate within each lymphatic drainage area between patients with SiewertⅡandⅢAGE ( P=0.090-1.000) .The lymph nodes with the most frequent recurrence were No.16b1, No.16a2, No.9, No.16b2, No.11p, and No.7 in patients with stage N3 AGE and No.11p, No.16b1, No.16a2, No.9, No.8, and No.7 in patients with stage non-N3 AGE.Patients with stage N3 AGE had a significantly higher recurrence rate in the para-aortic regions (No.16a2-b2) than those with stage non-N3 AGE (67%vs.33%, P=0.004, OR=4.00, 95% CI=1.54-10.37) .Conclusions The lymph nodes with the highest risk of recurrence are located in the celiac artery, proximal splenic artery, and retroperitoneal areas ( No.16a2 and No.16b1) in patients with SiewertⅡorⅢlocally advanced AEG.Moreover, patients with stage N3 AGE have a higher risk of retroperitoneal recurrence.The above areas should be involved in target volume delineation for postoperative radiotherapy.
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BACKGROUND:After entering the aging society, improving the balance function to prevent fals and reduce incidence of fractures in the elderly has received widespread attentions in al aspects. OBJECTIVE: To design a training program for the elderly, involving static stretching and strength exercise of lower limb, in order to study the combined effect on the balance function of the elderly. METHODS: Static stretching and strength training of the lower limbs were carried out in 28 elderly persons who met the inclusion criteria for 3 months, three times a week, once for 60 minutes. Before and after exercise training, the static balance ability with foot standing, eyes open and eyes closed was evaluated using the PRO-KIN balance instrument; the dynamic balance ability and lower limb strength were evaluated using treadmil test with eyes closed and chair-stand test. Evaluation results before and after exercise were compared and anayzed. RESULTS AND CONCLUSION:In the eyes open state, the average X-axis coordinate and exercise-induced elipse area at the center of pressure were significant different before and after exercise (P < 0.01); the mean velocities at the left and right direction were of significant difference before and after exercise (P < 0.05); the results of treadmil test with eyes closed and chair-stand test also presented very significant differences before and after exercise (P < 0.01). Static stretching combined with lower limb strength exercise can effectively improve the balance function and lower limb strength of the elderly, which can be used as an effective exercise way to prevent the fals in the elderly.
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Objective To investigate the effect of Iscom matrix on the immunogenicity of recombinant hepatitis B surface antigen containing PreS epitopes(SS1S2). Methods SS1S2+ Al(OH)3 and SS1S2+Iscom vaccines were made by combining purified SS1S2 antigen with Al( OH)3 adjuvant or Iscom matrix.Groups of BALB/c mice were injected i. m or s. c by either of the two vaccines at day 0 and day 14. Half of the mice were sacrificed and sera were taken and spleen cells separated from the mice 14 days after each injection. Anti-S, anti-PreS1, and anti-PreS2 antibody titers were measured, and total IgG1 and IgG2a titers were further detected for each serum sample. IFN-γ ELISPOT assay was performed to detect IFN-γsecreting cells from the pooled spleen cells for each vaccine group. Results The seroconversion rates and geometric mean titers(GMTs) and the numbers of IFN-γ secreting cells were approximately at the same level for the differently formulated vaccines after the first injection except that the ratio of IgG2a to IgG1 in the Iscom group was higher than the Al(OH)3 group. After boost injection, the GMTs of total IgG rise slightly in the Al(OH)3 group but significantly in the Iscom group. The IgG2a to IgG1 ratio in the Iscom group kept balanced while dropped further in the Al(OH)3 group. The number of specific IFN-γsecreting cells triggered by the Iscom vaccine exceeded significantly the number of Al( OH)3 vaccine, showinga stronger cellular response. Conclusion The results in this study shows that Iscom matrix is more potent in enhancing the immunogenicity of recombinant hepatitis B virus surface antigen containing PreS epitopes than Al( OH)3 adjuvant.
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Objective To assess the value of 64-slice CT colonography (CTC) in diagnosing colorectal neoplasms. Methods One hundred and thirty-two patients with suspected colorectal neoplasm underwent 64-slice spiral CT after bowel cleaning and rectal air insufflating, double contrast barium enema (DCBE) and colonoscopy. CT data were transmitted to the workstation and was performed respectively. All images were separately evaluated by two experienced radiologists. The sensitivity, specificity and accuracy of the CTC and DCBE were evaluated and compared with that of colonoscopy or surgical biopsy. Results The sensitivity, specificity and accuracy of CTC was 96.49%, 90.91% and 95.59%, of DCBE was 91.23%, 72.73% and 88.24% (χ~2=0.566, P=0.319). In neoplasms with diameter ≤5.0 mm, the sensitivity, specificity and accuracy of CTC was 80.95%, 86.96% and 84.09%, of DCBE was 57.14%, 69.56% and 63.64% (χ~2=0.679, P=0.422). In neoplasms with diameter of 5.1-9.9 mm, the sensitivity, specificity and accuracy of CTC was 91.67%, 100% and 94.12%, of DCBE was 75.00%, 80.00% and 76.47% (χ~2=0.631,P=0.374). The sensitivity, specificity and accuracy of both CTC and DCBE for detecting neoplasms with diameter ≥10.0 mm was 100%. Conclusion CTC is valuable in detecting colorectal neoplasm as a noninvasive method.
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Objective To assess the value of rigid wall and outer coarse signs in 64-slice CT for pre-operation stages of colorectal carcinoma. Methods One hundred and twenty-three colorectal carcinoma patients underwent 64-slice CT;then rigid wall and out coarse signs were evaluated respectively. The tumors were grouped according to the postoperative pathologic infiltrative depth. Two signs of the neighboring infiltrative depth groups were compared and analyzed, so as the relativity between two signs and tumor infiltrative depth. Results Among all 123 patients, 7 were Tis, 6 were T1, 14 were T2a, 16 were T2b, 75 were T3 (including 22 infiltrate to chorion and 53 infiltrate through chorion) and 5 were T4. According to the pathologic infiltrative depth, the patients were grouped into GroupⅠ: Tis+T1;GroupⅡ: T2a;Group Ⅲ: T2b;Group Ⅳ: T3a;Group Ⅴ: T3b+T4. Significant difference of the incidence of rigid wall was found between GroupⅠand Ⅱ (P=0.013), while of outer coarse between Group Ⅱ and Ⅲ (P=0.004). Coefficient correlation of rigid wall, outer coarse and the infiltrative depth of the tumor were detected (r=0.673, r=0.528, respectively, both P＜0.001), also between the two signs (r=0.725, P＜0.001). To predict the tumor of and above T1 with rigid wall and tumor of and above T3a with outer coarse, the sensitivity, specificity and accuracy was 92.30% and 79.31%, 89.09% and 69.44%, 89.43% and 76.42%, respectively. Conclusion The sign of rigid wall is valuable to distinguish the pathological changes in the tumor of and above T1, while outer coarse is better to distinguish the pathological changes of and above T2a, but not good at distinguishing tumors of T2b and T3 or above. Rigid wall and outer coarse are both in positive correlation with the infiltrative depth of the tumor, and each has different values. Combination of the two signs may be helpful to raise the accuracy for pre-operation staging of colorectal carcinoma.
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Objective To study the alveolar macrophages (AM) activation in neutropenic ARDS in children with hematologic malignancy. Methods Thirteen patients of ARDS were prospectively enrolled into the study and divided into two groups,neutropenic (5 cases) and nonneutropenic (8 cases). Bronchoalveolar lavage fluid (BALF) samples were analyzed for differential and total cell counts, and alveolar activation marker expression (HLA-DR) was determined. Results In neutropenic patients,the BALF total cell count and the macrophage absolute count were significantly lower compared to those in nonneutropenic group ((62. 6 ±9. 6)/μl vs ( 124. 0 ± 6. 7)/μl,P ＜ 0. 01 and (40. 8 ±4. 3)/μl vs (67. 6 ± 10. 7)/μl,P ＜ 0. 01,respectively). As compared with the nonneutropenic group, the percentage of AM in neutropenic patients was significantly higher (65.9% ±9. 0% vs 54. 6% ± 8. 7% ,P ＜0. 05) ,the mean percentage of AM HLA-DR expression was significantly lower (35. 3% ± 5.8% vs 62. 2% ± 5. 8%, P ＜ 0. 01 ). Conclusion These results suggest an alveolar hypocellularity and a deactivation of AM in neutropenic ARDS in children with hematologic malignancy.
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Objective To set up the optimized conditions,the amplification of eord blood CDCD+34 cells in vitro were analyzed by comparing the conditions such as different feeder-layers, stimulating-factors or purity/contents of those cells. Methods The cord blood CDCD+34 cells proliferation was analyzed by the methods of MTT, cell counting, and flow eytometer. The amplification and clone-forming ability of cord blood CDCD+34 cells were detected under optimized condition. Resulits The growth rates of cord blood CD+34 cell under optimized conditions(10 times) were significantly higher than that of the control(2.8 times) (P ＜0.01), and the cloneforming ability of cord blood CDCD+34 cells under optimized conditions(CFU-C 36.67±6.11) were also better than that of the control(CFU-C 16.33±1.53) (P ＜0.01). Conclusion The cord blood CD+34 cells proliferation can be promoted in the co-cultured system, and the character of the stem cells were kept well in that system.
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Objective To evaluate the role of endorectal ultrasonography with coupling gel intrarectal filling in preoperative T stage of rectal cancer. Methods One hundred and fifteen patients with rectal cancer underwent endorectal ultrasonography with coupling gel intrarectal filling. The preoperative T stage according to ultrasonic manifestations was compared with histological findings. Results The total diagnostic accordance rate of preoperative T stage by endorectal ultrasonography with coupling gel intrarectal filling was 89.57%. The sensitivity of ultrasonography for T1, T2, T3 and T4 was 93.10%, 61.11%, 96.61%, 88.89%, while the specificity was 97.67%, 96.91%, 89.29%, 99.06%, respectively. The overstaging rate of ultrasonography was 6.96% (8/115), and the understaging rate was 3.48% (4/115). Conclusion Endorectal ultrasonography with coupling gel intrarectal filling is a valuable diagnostic method for T stage of rectal cancer.
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Objective To explore the diagnostic value of thin image and multiplanar reconstruction (MPR) for preoperative T staging on different regions and various pathological staging of colorectal cancer. Methods A total of 163 colorectal cancer patients underwent 64-slice CT examination, then cross section image with thickness of 5 mm (5 mm interval) and 0.5 mm (0.4 mm interval) were reconstructed. The lesions were evaluated and T staged with 5 mm, 0.5 mm and MPR image, respectively. Patients were divided according to the region of lesions: groupⅠ: the anterior wall of lower rectal or near dentate line; groupⅡ: the posterior or lateral wall of lower rectal; group Ⅲ: upper middle rectal or clone. Patients in group Ⅲ were divided into 4 subgroups according to postoperative pathological staging: group A: Tis and T1; group B: T2 (B1: T2a; B2: T2b); group C: T3; group D: T4. The accurate diagnostic rates of different regions, different imaging techniques and different pathological staging were analyzed compared with postoperative pathological results. Results CT accurate T staging diagnostic rate for group Ⅰ, Ⅱ, Ⅲ was 44.44%, 61.54% and 66.67% respectively with 5 mm; 51.85%, 61.54% and 69.92% respectively with 0.5 mm; 51.85%, 76.92% and 78.86% with MPR. There was significant difference of CT accurate diagnostic rates only between group Ⅰ and group Ⅲ (5 mm P=0.031, MPR P=0.004). MRP was better then 5 mm and 0.5 mm only in group Ⅲ (P=0.008, P=0.019). The sensibility of diagnostic T staging of A, B, C and D subgroup in group Ⅲ was as follows: 53.85%, 30.00%(B1: 57.14%, B2: 6.25%), 84.00% and 60.00% with 5 mm; 76.92%, 33.33%(B1: 76.92%, B2: 18.75%),84.00% and 60.00% with 0.5 mm; 92.31%, 53.33%(B1: 78.57%, B2: 31.25%), 86.67% and 80.00% with MPR. CT accurate T staging diagnostic rate of subgroup B2 was significantly lower than those of other groups, and most of the errors were over valuated. Conclusion CT has good sensitivity, specificity and accuracy for diagnostic T staging for early colorectal cancer. MPR can raise the accurate diagnostic rate of upper middle rectal and colon tumor. CT diagnostic value for T staging of lesions at the anterior wall of lower rectal or near dentate line tumor is limited, and the primary cause is over diagnosis of T2b lesions.
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Objective To assess the value of 64-slice CT colonography (CTC) in preoperative TN staging of colorectal carcinomas. Methods One hundred and sixty-eight patients with suspected colorectal neoplasm underwent 64-slice spiral CTC after bowel cleaning and rectal air insufflating, among them 91 patients were proved with surgical pathology and enrolled into this study, and CTC images were reviewed separately by two experienced radiologists for preoperative TN staging of the tumors. Results For CTC evaluation of T staging, the sensitivity, specificity and accuracy were 98.57% (69/70), 85.00% (17/20) and 92.31% (84/91), respectively. The sensitivity, specificity and accuracy of CTC N staging were 87.80% (36/41), 96.00% (48/50) and 82.42% (75/91), respectively. Conclusion 64-slice spiral CTC plays a significant role in the preoperative TN staging of colorectal carcinoma.
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Objective The expression of IL-13 in plasma and renal tissue was studied to eluciate the molecular pathogenesis of Mesangial proliferative glomerulonephritis (MsPGN). Methods Plasma level of IL-13 in patients with MsPGN and in normal control groups were examined by ELISA. The expression of IL-13 in patients with MsPGN and in control group were examined by immune histochemistry ABC technique in renal tissue.Results Plasma levels of IL-13 in patients with MsPGN were significantly higher than that in control group,and the highest was found in IgAN;IL-13 expressions in glomerulus and tubulointerstitial zone in patients with MsPGN were higher than that in control group, and IL-13 expression in tubulointerstitial zone was more strong,but it was not distinctive difference between non-IgA MsPGN and IgAN. Conclusion IL-13 may play an important role in the molecular pathogenesis of MsPGN.
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Objective To evaluate breast imaging reporting and data system (BI-RADS) in categorization and biopsy of nonpalpable breast lesions (NPBLs). MethodsOne hundred and sixty-two NPBLs from 144 female patients detected by mammography were retrospectively categorized according to BI-RADS. All the lesions finally got histopathological diagnosis by wire-localization biopsy. Results There were 46 malignant lesions, with the positive predictive value for cancer of 28.4% (46/162). The cases of BI-RADS 2-5 lesions were 11, 55, 77, and 19 after categorization according to the BI-RADS, and the positive predictive value of each category for cancer was 0% (0/11),3.6% (2/55),37.7% (29/77),78.9% (15/19) respectively. ConclusionBI-RADS categorization improves the diagnostic specificity of nonpalpable breast lesions and helps decision-making for biopsy. It is suggested that NPBLs on category of BI-RADS 4 or 5 should undergo biopsy.