Predictive value of neutrophil-to-lymphocyte ratio in adult severe tetanus / 中华传染病杂志

Objective:To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) for adult severe tetanus by comparing the NLR in patients with severe and mild tetanus.Methods:A total of 65 adult tetanus patients from the Linyi Central Hospital from January 2009 to December 2020 were enrolled. The patients were divided into two groups including mild group and severe group according to the Ablett classification. The general conditions, laboratory data, and NLR of patients in two group were retrospectively compared using independent samples t test. Multivariate logistic regression analysis was used for the analysis of risk factors for severe tetanus. Spearman correlation method was used for the analysis of the correlation between risk factors and Ablett grades. Receiver operator characteristic (ROC) curve was used for the evaluation of the predictive value. Results:Among the 65 tetanus cases, 34 was in mild group and 31 in severe group. The latency period of patients in severe group was (7.00±3.19) d, which was shorter than that in mild group ((9.18±2.59) d), and the difference was statistically significant ( t=3.03, P=0.004). The NLR of patients in severe group was 4.251±1.936, which was higher than that of mild group (2.533±1.026) , and the difference was statistically significant ( t=4.41, P<0.001). Multivariate logistic regression analysis showed that NLR and latency period were independent risk factors for tetanus severity (odds ratio ( OR)=2.359, 95% confidence interval ( CI) 1.415 to 3.934, P=0.001 and OR=0.748, 95% CI 0.599 to 0.936, P=0.011, respectively). In tetanus patients, the NLR level was positively correlated with Ablett grade ( r=0.644, P<0.001). The ROC curve showed that NLR had good predictive value for adult severe tetanus at a cut-off value of 2.471 (area under the curve (AUC)=0.787), with the sensitivity and specificity of 87.1% and 61.8%, respectively. When combining NLR with latency period (cut-off value of 7.5 d), predictive efficiency was further improved (AUC=0.832) with the sensitivity of 87.1% and specificity of 67.6%( Z=3.43, P<0.001). Conclusions:NLR has a good predictive value for adult severe tetanus, and the predictive efficiency is further improved when combined with latency period.

The clinical and MR features of intracranial nonspecific inflammatory granuloma / 实用放射学杂志

Objective To analyze the clinical and MR features of intracranial nonspecific inflammatory granuloma and improve the accuracy of preoperative diagnosis.Methods The clinical and MR features of 9 intracranial nonspecific inflammatory granuloma cases proved by histopathology were analyzed retrospectively.Results Nine lesions were all located in the supratentorial cerebral hemisphere with large lesion range and obvious peripheral edema.On enhancement MR imaging,the lesions were obviously and irregularly enhanced.There were simple patchy enhancement in 3 cases,patchy enhancement with multiple micronodular enhancement in 4 cases,and multiple micronodular enhancement in 2 cases.None enhancement areas were noticed in all enhancement lesions.There were superficial meningeal enhancements in 4 cases.On MR plain scanning,the MR enhancement area of lesions showed similar signal to the grey matter on T1 WI and low signal similarly to the white matter on T2 WI.On MRS scan,the significant high signal of Cho was detected in 2 cases and their Cho/Cr ratio was over 4.The Cho/Cr ratio was lower than 1.3 in 5 cases.Conclusion There are some specific MR enhancement features in the intracranial nonspecific inflammatory granuloma including multiple small nodules or patchy enhancement,in which there were no enhancement areas,and some cases have meningeal enhancement.

Clinical and MR features of oligodendroglioma / 实用放射学杂志

Objective To study the MR features and differential diagnosis of oligodendroglioma.Methods Clinical and MR data of 34 pathology-diagnosed oligodendroglioma cases were analyzed retrospectively, which included tumor location,signal,size,enhanced and MRS features.Results 22 cases were diagnosed as WHOⅡoligodendroglioma and 12 cases WHOⅢ anaplastic oligodendroglioma.22 tumors located in the frontal lobes,4 tumors in the temporal lobes, 7 tumors in both frontal and temporal lobes,1 tumor located at the optic chiasma.25 tumors located in the superficial areas of the brain.For anaplastic oligodendrogliomas,tumor necrosis and cystic degenerations were showed in 11 cases,and hemorrhage or calcification in 6 cases.For oligodendroglioma,tumor necrosis and cystic degenerations were showed in 6 cases,hemorrhage in 2 cases,calcification in 8 cases.The average tumor diameter was 35 mm for oligodendroglioma and 58 mm for anaplastic oligodendroglioma.For anaplastic oligodendroglioma,obvious irregular or ring enhancements were showed in 11 cases.For oligodendroglioma, mild enhancement was showed in 6 cases,no enhancement in 6 cases and mild or moderate irregular ring-type enhancements in 4 cases.MRS was performed in 6 anaplastic oligodendrogliomas the Cho/Cr ratio was over 4 in 5 cases.MRS was performed in 12 oligodendrogliomas the Cho/Cr ratio was between 2.3 to 3.3 in 10 cases and below 2 in 2 cases.Conclusion The main MR feature of anaplastic oligodendroglioma is that tumor is located in the frontal lobe and superficial area of the brainwith irregular or ring-type enhancement,and the Cho/Cr ratio over 4.

Nano-carbon tracer technology mapping lymph node dissection in laparoscopic mid-low rectal cancer resection / 中国现代普通外科进展

Objective:To investigate the clinical application value of nano-carbon tracer technology in lymph node dissection and postoperative pathological examination in laparoscopic mid-low rectal cancer resection.Methods:Fifty-two patients with mid-low rectal cancer were randomly divided into experimental group (n=27) and control group (n=25).Before surgery,the Nano-group were injected nano activated carbon suspension liquid under the mucosa.Both groups were accepted the same principles of open colorectal cancer radical surgery.The total number of lymph nodes,number of tiny lymph nodes,number of black dye and number of metastasis lymph node confirmed by pathology in the two groups were statistical analysised.Results:There were 905 pieces of lymph node seized in two groups toally,including (20.67 ± 5.751) medals in Nano-carbon group and (13.88 ±4.466) medals in control group.Lymph node number in nano carbon group was more than control group (P＜0.01).Nano-carbon group seized 113 tiny lymph nodes,significantly higher than 49 in the control group (P＜0.05).The metastasis rate of lymph node was no significant difference in the two groups (P＞0.05).Nano-carbon group seized lymph node metastasis was no significant difference in the rate of the control group (P＞0.05).Nano-carbon group seized 341 black dyed lymph nodes and 217 not black dye lymph nodes.And 67 cases of metastasis lymph nodes in Black dye lymph nodes,15 cases of metastasis lymph nodes in not the black dye lymph nodes.The metastasis rate of black dye lymph node was higher(P＜0.01).Conclusions:Nano-carbon tracer technique can guide the surgeon to accurately lymph nodes dissection during the operation,and can add to the number of lymph nodes in the postoperative surgical specimens,improve lymph nodes in patients with colorectal cancer radical seized quantity.Nano-carbon tracer technique can ensure the accuracy of the pathological staging,there was important clinical significance to lymph node dissection in Mid-low colorectal cancer,which provide an important basis for the development of postoperative adjuvant therapy programs.

Clinical and MR features of fungal encephalopyosis and granuloma / 实用放射学杂志

Objective To investigate the clinical and MR features of fungal encephalopyosis and fungal granuloma.Methods The clinical and MR data of 10 cases with fungal encephalopyosis and fungal granuloma confirmed by surgical pathology or clinical serum were analyzed retrospectively.Then we analyzed the clinical conditions,MR signals,lesion enhancement,DWI and MRS performance characteristics of the 10 cases.Results Six cases were fungal encephalopyosis,among which 2 cases occurred in the sella turcica after surgery which located in and above the sella turcica.2 cases occurred in the frontal lobe after frontal surgery and 1 case of them was multiple encephalopyosis.2 cases of encephalopyosis without operation history were located in the left frontal lobe and right cerebellum respectively.The abscess walls of these cases were thin and showed high tension.Furthermore,it had annular significant signal enhancement and high signal in DWI scan.One case of huge fungal granuloma located in the frontal lobe and into the sinuses which showed uneven signal enhancement. The Cho level was significantly increased.Three cases of cryptococcal granuloma showed multiple lesions located in the bilateral basal ganglia region and 2 out of them accompanied with cephalomeningitis.Conclusion The MR performance of fungal encephalopyosis was quite similar with bacterial brain abscesses,which makes the differential diagnosis difficult.The brain fungal granuloma MRS may display a significant increase of Cho level which might be related with gliosis.It shows certain characteristics of brain MR performance of cryptococcal granuloma which are multiple lesions,preferential distribution of basal ganglia region and accompanying cephalomeningitis.

Study of proton magnetic resonance spectroscopy in normal human brain / 西安交通大学学报(医学版)

0.05);some ratios in the three parts between the young group and old group showed significant difference(P

~1H-MRS in bilaterlis frontal lobe and hippocampus of patients with first episode major depression after SSRIs antidepressant treatment / 西安交通大学学报(医学版)

Objective To measure neuro-biochemical changes in brain of first episode major depression (MD) patients. Methods Single-voxel proton magnetic resonance spectroscopic (1H-MRS) examination of bilateralis frontal lobe and hippocampus was conducted in 21 first episode major depression patients and 21 age-, sex-and education-matched healthy controls. After this, major depression patients took selectivity serotonin reuptake inhibitors (SSRIs) for three months. Then, we examined the changes in NAA, Cho, Cr, Glx and mI in bilaterlis frontal lobe and hippocampus of patients. Finally, we compared the metabolism of the subjects with that of the controls. Results ① Bilateralis frontal lobe NAA/Cr, right frontal lobe Glx/Cr and left hippocampus NAA/Cr and Glx/Cr were significantly lower in MD patients than in the controls, but right frontal lobe and right hippocampus mI/Cr significantly were higher than those in controls. ② After treatment left frontal lobe and left hippocampus NAA/Cr significantly increased compared with pretherapy. Right frontal lobe mI/Cr significantly decreased. Conclusion Nerve cell activity disorder, abnormal second messenger and glutamicacid and glutamine may be involved in the pathogenesis of MD. Antidepressant can regulate abnormal metabolism and improve nerve cell activity.

The Study of ~1 HMRS in Diagnosis of Astrocytoma / 实用放射学杂志

Objective To assess the value of ~1 HMRS in the classification and differential diagnosis of astrocytoma. Methods 58 cases of astrocytoma including 18 cases of diffuse astrocytoma, 24 cases of anaplastic astrocytoma and 16 cases of glioblastoma were all examined by routine MR scan and ~1 HMRS, statistical analysis was done on Cho/Cr, Cho/NAA and NAA/Cr ratio. Results Diffuse astrocytoma showed slightly elevated Cho, a bit decreased NAA and Cr. Lac wave did not appear. Anaplastic astrocytoma and glioblastoma both manifested distinctly elevated Cho, obviously decreased NAA and Cr. Lac wave existed in 6 cases. In diffuse astrocytoma the ratio of Cho/NAA was 2.72?1.16, Cho/Cr was 2.66?1.21, NAA/Cr was 1.02?0.34. In anaplastic astrocytoma the ratio of Cho/NAA was 5.69?1.32, Cho/Cr was 4.92?1.46, NAA/Cr was 0.92?0.16. In glioblastoma the value of Cho/NAA was 5.71?1.08, Cho/Cr was 5.12?1.76, NAA/Cr was 0.87?0.13.Conclusion It is very significant of ~1 HMRS in the classification and differential diagnosis of astrocytoma.

CT,MR and MRS Diagnosis of Basal Ganglia Infarction / 实用放射学杂志

Objective To discuss imaging differentiating diagnosis of basal ganglia infarction by summarizing the features of 17 lesions on CT and MRI.Methods Among 17 cases, 6 were children occurred after their injury, and ranged in age from 5 to 11 years old with average 8 years old. Others were adults ranged in age from 53 to 78 years old with average 63 years old. All patients were examined with CT plain scans. 11 cases were underwent MRI and 5 were underwent 1 H MRS.Results 6 lesions in children were all single lateral cases. Among 11 adult lesions, 10 were single lateral and 1 was bilateral case. Basal ganglia infarctions demonstrated hyposignal on T_1WI, hypersignal on T_2WI and hypodense on CT. The lateral ventricles' anterior horns of the same side were pressed and narrow. On 1 H MRS, Lac was obviously observed in all lesions. NAA decreased markedly in 4 lesions and slightly in 1 lesion. 2 basal ganglia infarctions were together with hemorrhage.Conclusion Basal ganglia infarctions were mainly observed in the elder with arteriosclerosis and injured children. Its features on CT and MRI are characteristic, but it is in need of differentiating from basal ganglia lesions caused by other reasons. Marked Lac on 1 H MRS is its character.

CT Diagnosis of Follicular Thyroid Adenoma / 实用放射学杂志

Objective To investigate the CT manifestations of follicular thyroid adenoma.Methods CT manifestations of follicular thyroid adenoma proved by operation and pathology in 19 cases were analyzed retrospectively.Results Of 19 cases,5 cases were male and 14 cases were female,the average age was 36.6 years old.There were single focus in 17 and multiple focus in 2.All lesions were round or round-like.The lesions were homogeneous low density with smooth clear edges on plain CT scans.2 cases showed calcification in tumor.All cases had slight enhancement on contrast-enhanced CT scans.Conclusion CT manifestations of follicular thyroid adenoma are mostly typical which appear round or round-like,with clear smooth edges and most of which can be correctly diagnosed.

1H-MRS in frontal lobe and hippocampus of patients with first episode major depression / 西安交通大学学报(医学版)

Objective To measure metabolism in brain of first episode major depression patients with 1H-MRS.Methods Single-voxel proton magnetic resonance spectroscopic(1H-MRS) examination of bilateralis frontal lobe and hippocampus was conducted in 23 patients with first episode major depression and 23 age-,sex-and education-matched healthy controls.We examined the metabolism such as NAA,Cho,Cr,Glx and mI in bilaterlis frontal lobe and hippocampus of patients.Results Bilateralis frontal lobe NAA/Cr,right frontal lobe Glx/Cr and left hippocampus NAA/Cr and Glx/Cr were significantly lower in MD patients versus controls,but right frontal lobe and right hippocampus mI/Cr significantly higher than in controls.Conclusion Nerve cell activity disorder,abnormal second messenger and glutamicacid and glutamine may be involved in the pathogenesis of major depression.