Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: A Single-center Initial Experience from China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Urolithiasis in pediatric population is a serious problem with the incidence increased these years. In the management of larger stones (diameters >2 cm), percutaneous nephrolithotomy (PCNL) is considered to be the gold standard. This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged <3 years.</p><p><b>METHODS</b>We reviewed 68 patients (80 renal units) aged <3 years between August 2006 and December 2014 in Peking University People's Hospital and Beijing Tsinghua Changung Hospital, including 36 renal units with a single stone, 6 with staghorn stones, 14 with upper ureteral stones, and 24 with multiple stones. The mean age of the patients was 24.2 months (range 6-36 months), and the mean maximum stone diameter was 19.2 mm (range 10-35 mm). The puncture site selection and tract dilation were guided by Doppler ultrasonography solely. All procedures were performed using 12-16 Fr tracts. Stones were fragmented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope.</p><p><b>RESULTS</b>Fifty-six patients with unilateral stones underwent a single session procedure, and 12 patients with bilateral stones underwent two procedures. The mean time to establish access was 2.8 min (range 1.8-5.0 min), the mean operative time was 36.5 min (range 20-88 min), the mean decrease in hemoglobin concentration was 8.9 g/L (2-15 g/L), and the stone-free rate (SFR) at hospital discharge was 94.0%. The mean postoperative hospital stay was 7.1 days (range 3-13 days). Postprocedure complications included fever (>38.5°C) in five patients and reactive pleural effusion in one patient. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed.</p><p><b>CONCLUSIONS</b>This study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged <3 years, without major complications or radiation exposure.</p>

CT and MRI features of Castleman's disease of the abdomen and pelvis / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the CT/MRI features of Castleman's disease of the abdomen and pelvis.</p><p><b>METHODS</b>CT/MRI images of 6 cases of pathologically confirmed Castleman's disease of the abdomen and pelvis were retrospectively reviewed. All the patients received plain CT scan and dynamic enhanced scan, and one had an additional MR scan.</p><p><b>RESULTS</b>One case was identified as the disseminated type with multicentric enlarged lymph nodes and hepatosplenomegaly, and 5 cases were found to have localized type, of which 3 had retroperitoneal, 1 had mesentery and 1 had pelvic lesions. On CT scan, all the 5 cases with localized lesions showed single, round or ellipse soft tissue masses, with intra-tumoral calcification in 2 cases, fascial thickening around the mass in 3 cases, and satellite nodules in 4 cases. Enhanced scanning revealed obvious enhancement in the arterial phase and continuous enhancement in the portal vein and delayed phase in all the lesions, with an attenuation pattern similar to that of large vessels; enlarged blood vessels within or around the mass were displayed in each case. In 4 cases, the intra-tumoral radial or fissured non-enhanced areas in early stage of enhancement were gradually filled up as the scan time was delayed. The patient receiving MRI showed hypo-intensity on T(1)WI and hyper-intensity on T(2)WI, presenting with an enhancement feature similar to that of CT.</p><p><b>CONCLUSION</b>Castleman's disease in the abdomen and pelvis is rare and liable to misdiagnosis, but its characteristic imaging features can help in the diagnosis and differential diagnosis.</p>

Computed tomography and magnetic resonance imaging features of desmoid-type fibromatosis: comparison with the pathological findings / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the computed tomography (CT) and magnetic resonance imaging (MRI) features of desmoid-type fibromatosis, and improve the diagnostic accuracy and understanding of the disease.</p><p><b>METHODS</b>The CT and MRI features of 18 cases of surgically and pathologically confirmed desmoid-type fibromatosis were reviewed retrospectively. Among the patients, 10 received CT pre- and post-contrast scanning, and 8 patients had MRI pre- and post-contrast scanning. The CT and MRI features were analyzed in comparison with the pathological findings.</p><p><b>RESULTS</b>In the extra abdominal cases, the tumors occurred in the head and neck in 3, in the dorsal part of the chest in 2, in the abdominal wall and groin area in 9, and in the peritoneal cavity in 4; concomitant Gardner syndrome was found in 1 case. In 4 cases the tumor occurred within 1 to 3 years after abdominal surgeries. Pathologically, the lesion was hard and composed of fusiform fibroblasts and myofibroblast. The cells showed no obvious heteromorphism with few karyokinesis, growing invasively and recurrent locally but without distant metastasis. Immunohistochemically, the fibroblasts and myofibroblasts expressed vimentin, and the myofibroblasts were positive for SMA. On CT and MRI, the lesion appeared benign with malignant growth pattern, and caused compression of the adjacent organs and vessels or encasement of the vessels; the border was unclear without encapsulation, and necrosis and calcification was scarce. The density and signal of the tumor were well distributed. Twelve patients displayed obvious enhancement and 5 showed uneven enhancement.</p><p><b>CONCLUSION</b>The CT and MRI features of desmoid-type fibromatosis are characteristic, and CT and MRI are valuable modalities for the diagnosis and differential diagnosis of the tumor.</p>

Experimental study on monitoring gene expression by noninvasive method in rabbit VX2 liver tumor model / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of monitoring therapeutic effect of adenovirus vector containing IL12-IRES-CKb gene on a rabbit VX2 liver tumor model by using phosphorous-31 magnetic resonance spectroscopy (31P MRS).</p><p><b>METHODS</b>A total of 18 healthy New Zealand White rabbits were used to generate animal models by implanting VX2 tumor chips into livers through laparotomy. Tumor-bearing animals were randomly divided into three groups and were injected with AdCMVIL12-IRES-CKb, AdCMV-Empty and saline respectively via ear veins. 31P MRS scan was performed after animals were fed with creatine solution for five days. Animals were euthanized thereafter and tumors were removed for pathological examination, immunohistochemistry (IHC) staining and protein analysis (Western blot).</p><p><b>RESULTS</b>The intrahepatic and seral expressions of creatine kinase (CKb) and IL-12 were detected only in AdCMVIL12-IRES-CKb group. Tumor diameters pre- and post- treatment in three groups were 1.63+/-0.04 vs 1.62+/-0.03 in AdCMVIL12-IRES-CKb group (P = 0.229), 1.59+/-0.05 vs 1.84+/-0.11 in AdCMV-Empty group (P = 0.003) and 1.60+/-0.02 vs 2.07+/-0.12 in saline group (P = 0.001), respectively. Pcr Changes between pre- and post- treatment among the three groups were compared (F = 6.235, P value is less than 0.05). PCr increased significantly in AdCMVIL12-IRES-CKb group as compared to AdCMV-Empty (P = 0.004) and saline group (P = 0.049), whereas no change found between AdCMV-Empty and saline group (P = 0.153).</p><p><b>CONCLUSION</b>31P MRS, an effective and non-invasive functional imaging method, can be used to monitor the therapeutic effect of adenovirus vector containing IL12-IRES-CKb gene on rabbit VX2 liver tumor model through detecting metabolic product of imaging reporter gene CKb (pCr).</p>

Initial study of quantitative analysis of fatty liver by ~1H-MR spectroscopy imaging / 中华放射学杂志

Objective To investigate the feasibility of ~1H-MR spectroscopy(~1H-MRS)imaging to quantitatively detect fatty liver.Methods Twenty patients with fatty liver and 11 healthy volunteers underwent plain CT scan,conventional MR imaging and ~1H-MRS analysis.The blood lipid and liver function were tested on the same day as the MR examination.~1H-MRS sequence measured the peaks of H_2O and lipid,and the areas under the peaks.The relative contents of the lipid compound were calculated,and compared with the results of CT scan and liver function tests.Results The CT values of the normal group and the fatty liver group were(59?9)HU and(24?11)HU respectively.On ~1H-MRS a protruding high H_2O peak and a flat low lipid peak were observed in the normal group,while the protruding high H_2O peak and a high lipid peak appeared in the fatty liver group.The values of lipid peak in the normal group and the fatty liver group were(0.05?0.01)?10~5,(0.70?0.24)?10~5 respectively(t=4.32,P0.05),the areas under the lipid peak were(1.36?0.73)?10~9、(2.35?1.15)?10~9 respectively(t=5.21,P0.05).Conclusion ~1 H-MRS imaging is feasible to quantitatively detect liver fat and is a non-invasive method for detecting early fatty liver.