Evaluation parameters between intra-voxel incoherent motion and diffusion-weighted imaging in grading and differentiating histological subtypes of meningioma: A prospective pilot study.

PURPOSE: To prospectively evaluate the usage of intra-voxel incoherent motion (IVIM) magnetic resonance imaging (MRI) parameters in grading and differentiating histological subtypes of meningiomas and in comparing their ability with the traditional diffusion-weighted imaging (DWI) parameter (apparent diffusion coefficient, ADC). METHODS: In this prospective study, 102 participants underwent IVIM MRI and DWI. Traditional DWI and IVIM MRI were performed by using 2 b values (0, 1000s/mm2) and 12 b values (0-3500s/mm2), respectively. Finally, the values of ADC and IVIM parameters were collected from 72 Grade I and 11 Grade II meningiomas. RESULTS: The mean ADC values of Grade II and Grade I meningiomas were 0.909±0.268×10-3mm2/s and 0.905±0.194×10-3mm2/s, respectively, p=0.967. The D values were lower in Grade II meningiomas than in Grade I meningiomas (0.459±0.072×10-3mm2/s vs. 0.524±0.030×10-3mm2/s, respectively, p=0.005). In ROC curves, the cut-off D value that separated Grade II meningiomas from Grade I meningiomas was 0.479×10-3mm2/s with a sensitivity of 90.9% and a specificity of 76.7%. The secretory and angiomatous meningiomas had higher IVIM parameters than the other subtypes (all p<0.05). D* was significantly lower in fibrous meningiomas than in other meningiomas (2.783±1.179×10-3mm2/s vs. 5.125±1.918×10-3mm2/s, p<0.001). D, rD and rf values correlated negatively with Ki-67 index while D* and rD* value had positive relation with Ki-67 values. CONCLUSION: IVIM MRI is a promising technique for distinguishing different grades of meningiomas. Different subtypes of meningiomas have different IVIM features, which may help to treatment decision and prognosis evaluation.

Clinical effects of laparoscopic therapy and duodenoscopic therapy in the treatment of biliary severe acute pancreatitis / 重庆医学

Objective To discuss the clinical effects of laparoscopic therapy and duodenoscopic therapy in the treatment of biliary severe acute pancreatitis.Methods A total of 140 patients with biliary severe acute pancreatitis(BSAP) in our hospital was assigned into laparoscopic therapy group(60 cases) and duodenoscopic therapy group(80 cases) according to the treatment plan,and indicators in both groups were compared,including acute physiology and chronic health evaluation(APACHE Ⅱ score),WBC,CRP,the operation time,intraoperative blood loss,hospitalization time,hospitalization fee,complication rate,cure rate,mortality rate,abdominal pain disappearing time,body temperature recovered to normal time,blood amylase recovered to normal time,amino acid transaminase(ALT) recovered to normal time,total bilirubin(TBIL) recovered to normal time,alkaline phosphatase(ALP) recovered to normal time.Results APACHE Ⅱ scores and the levels of WBC,TBIL,ALT and CRP in both groups were significantly decreased after surgery(P＜0.05),but there were no statistical differences between the two groups at the same time point after treatment(P＞0.05).The operative time and the intraoperative blood loss in the duodenoscopic therapy group were significantly less than those in laparoscopic therapy group(P＜0.05).There were no statistical differences between the two groups of hospitalization time,complication rate,cure rate,mortality rate,abdominal pain disappearing time,temperature returned to normal time,blood amylase recovered to normal time,ALT recovered to normal time,TBIL recovered to normal time,ALP recovered to normal time(P＞0.05).Conclusion In early stage,both laparoscopic therapy and duodenoscopic therapy can treat BSAP effectively,and their therapeutic effects are nearly similar.

Cost-effectiveness Analysis of 4 Kinds of Protease Inhibitor Preventing Hyperamylasemia and Pancreatitis after ERCP of Choledocholithiasis Patients / 中国药房

OBJECTIVE:To evaluate the economics of somatostatin,ulinastatin,octreotide and gabexate preventing hyperamy-lasemia and pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). METHODS:Medical records of 316 cho-ledocholithiasis patients underwent ERCP were selected from our hospital during Jul. 2008-Apr. 2016,and then divided into blank control group(58 cases),somatostatin group(64 cases),ulinastatin group(65 cases),octreotide group(68 cases)and gabexate group (61 cases) according to the use of protease inhibitor. Before ERCP,blank control group received routine treatment as fast-ing,parenteral nutrition support,acid suppression,etc. Based on it,other 4 drug groups received prophylactic drug use according to package inserts 6 h before ERCP. The incidence of hyperamylasemia and pancreatitis after ERCP,VAS scores 3,24,48 h after surgery and the occurrence of ADR were compared among 5 groups. The cost-effectiveness analysis was used to evaluate the eco-nomics of therapy plans in each group. RESULTS:Compared with blank control group,hospitalization time of somatostatin group, ulinastatin group,octreotide group and gabexate group were shortened significantly;the incidence of hyperamylasemia and pancre-atitis were significantly decreased;VAS score 3,24,48 h after surgery were significantly decreased,with statistical significance (P0.05). The cost-effectiveness ratio of somatostatin group was the lowest and has cost-effec-tiveness advantage. The results were supported by incremental cost-effectiveness and sensitivity analysis. CONCLUSIONS:Soma-tostatin,ulinastatin,octreotide and gabexate can significantly prevent the occurrence of hyperamylasemia and pancreatitis after ER-CP,and relieve pain with good safety. Somatostatin can achieve the best therapeutic efficacy at the lowest cost,so it is the best plan for hyperamylasemia and pancreatitis after ERCP.

Effects of PTEN and its mutants on AKT phosphorylation in gastric cancer cells / 实用医学杂志

Objective To study the effects of PTEN and missense mutations in PTEN phosphotase domain on AKT phosphorylation in AGS and BGC-823 cells. Methods The plasmids of wtPTEN,PTEN-C124S which PTEN mutant is in both lipid and protein phosphotase domain and PTEN-G129E which PTEN mutant is only in lipid phosphotase domain were respectively transfected into AGS and BGC-823 cells. The cells were stimulated with insulin or rhEGF after serum starvation overnight. The levels of AKT phosphorylation were detected by Western blot. Results Both insulin and rhEGF can activate AKT phosphorylation in gastric cancer cells. Overexpressed PTEN inhibitedAKT phosphorylation induced by insulin or rhEGF(P 0.05). Conclusions PTEN can inhibit AKT phosphorylation induced by insulin or rhEGF in gastric cancer cells. Missense mutations in the 124th or 129th amino acid of PTEN phospho-tase domain do not exert inhibitive function.