ABSTRACT
Objective To investigate the value of dual-energy CT quantitative parameters combined with CT features for predicting perineural invasion(PNI)of colorectal adenocarcinoma.Methods Preoperative whole-abdominal CT data of 79 patients with colorectal adenocarcinoma confirmed by postoperative pathology were retrospectively analyzed.The patients were divided into PNI group(n=31)or no PNI group(n=48).Univariate analysis was used to compare CT features and dual-energy CT quantitative parameters between groups,and the variables with significant differences were included in binary logistic regression analysis to construct a combined model.Receiver operating characteristic(ROC)curves were drawn and area under the curve(AUC)were calculated,the efficacy of single CT parameters and combined model for predicting PNI of colorectal adenocarcinoma were evaluated.Results There were significant differences of the location of the primary lesion,the maximum thickness of the diseased intestinal wall,the presence or absence of peritumoral lymph node metastases,peritumoral mesenteric streak shadow and tumor deposits shown on CT between groups(all P＜0.05).Significant differences of the arterial phase slope of energy spectrum curve(λHU),iodine concentration(IC),normalized IC(NIC),dual energy index and the venous phase NIC of dual energy index were found between groups(all P＜0.05).AUC of the above single parameters for predicting PNI of colorectal adenocarcinoma ranged from 0.615 to 0.698,while of the combined model was 0.864.Conclusion Dual-energy CT quantitative parameters combined with CT features could be used to effectively predict PNI of colorectal adenocarcinoma.
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Objective To evaluate the clinical efficacy and safety of compound polymyxin B ointment combined with desonide cream for the treatment of subacute or chronic eczema. Methods A multicenter, randomized, double?blind, parallel?group, controlled clinical study was conducted. Totally, 144 patients with subacute eczema and 144 patients with chronic eczema were enrolled into this study, and both randomly and equally divided into the test group and control group. The test group and control group firstly topically applied compound polymyxin B ointment and its vehicle respectively, then both topically applied desonide cream 3 hours later. The drugs or vehicle were applied twice a day in all the patients. Patients′ symptoms and signs (including degree of itching, inflammation, erosion/exudation and infiltration/thickening, as well as area of target lesions) were evaluated, and the time to onset and duration of itching?alleviating effect were recorded. The clinical efficacy and safety of treatments were analyzed and compared between the test group and control group. Results The total symptom and sign scores significantly decreased to different extents on days 7 and 14 in the test group(subacute eczema patients:6.09 ± 2.78 and 3.68 ± 3.18 vs. 13.44 ± 1.66; chronic eczema patients: 6.56 ± 2.68 and 4.38 ± 3.27 vs. 12.96 ± 1.16)and control group(subacute eczema patients:8.26 ± 3.17 and 5.28 ± 4.05 vs. 13.60 ± 1.75;chronic eczema patients: 8.84 ± 2.90 and 6.25 ± 3.78 and vs. 12.64 ± 1.18)compared with those at baseline. Moreover, the total symptom and sign score of patients with subacute or chronic eczema was significantly lower in the test group than in the control group on days 7 and 14(all P<0.05). A significant increment was observed in the degree of decrease in scores for itch, infiltration/thickening in patients with subacute eczema in the test group compared with that in the control group(all P<0.01), as well as in scores for itch, infiltration/thickening and area of target lesions in patients with chronic eczema in the test group compared with those in the control group (all P < 0.05). In addition, patients with subacute eczema in the test group showed significantly shorter onset and longer duration of itching?alleviating effect than those in the control group(both P<0.05). The time to onset of itching?alleviating effect was also significantly shorter in patients with chronic eczema in the test group than in those in the control group(P<0.000 1), but there was no significant difference in the duration of it between the two groups of patients with chronic eczema. Clinicians and patients were both more satisfied with therapeutic effects in the test group than in the control group(all P<0.05). Conclusions Topical compound polymyxin B ointment can increase the efficacy of topical desonide cream for the treatment of subacute or chronic eczema, especially subacute eczema. Compound polymyxin B ointment also shows a favorable therapeutic effect on itching and infiltration/thickening in patients with eczema.
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Objective To assess the efficacy and safety of 308-nm excimer laser combined with topical tacrolimus 0.03％ cream for the treatment of childhood vitiligo on the face or neck.Methods Sixty-eight children aged ＜ or =14 years with vitiligo on the face or neck were enrolled in this study,and divided into two groups based on lesional sites,i.e.,skin group with lesions on the forehead,cheek,lower mandible,neck or in the periortic region and mucosa group with lesions in the perioral or periorbital region.All the patients received 308-nm excimer laser irradiation once or twice weekly and topical tacrolimus 0.03％ cream twice daily.Twenty sessions of irradiation served as a treatment course.Efficacy was evaluated at the end of the treatment course.The effects of erythema reaction and cumulative irradiation dose on efficacy were assessed.Results After 20 times of laser therapy,an excellent response was achieved in 78.4％ of the patients in the skin group,and 54.8％ in the mucosa group (P ＜ 0.05).During the treatment,the average frequency of erythema reaction lasting 48 hours or longer was significantly lower in the skin group than in the mucosa group (5.84 vs.9.12,P ＜ 0.01).After 10 and 20 times of laser therapy,the cumulative radiation dose was 4215 mJ/cm2 and 10 453 mJ/cm2 in the skin group,respectively,compared to 3364 mJ/cm2 and 7430 mJ/cm2 in the mucosa group,respectively (both P ＜ 0.01).Conclusions The 308-nm excimer laser combined with topical tacrolimus cream is effective and safe for the treatment of childhood vitiligo on the face or neck.Vitiligo on the forehead,cheek,lower mandible,neck and in the periortic region appears to respond better to this therapy with a weaker erythema reaction than that in the perioral or periorbital region.
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Two cases of nevus of Ota resistant to multiple sessions of Q-switched laser treatment are reported.Both of the patients were females,who developed beige or blue patches on the left side of the face (zygomatic region,cheek)several months after birth.No conjunctiva or sclera was involved.The lesions spread to the left retroauricular region and posterior neck during pregnancy in one patient.Histopathological examination of the lesions showed scattered melanocytes and melanophages in lower dermis and subcutaneous adipose tissue as well as apparent proliferation of collagen.Immunostaining for CD34 showed no abnormality in the distribution of vascular endothelial cells in these tissues.No obvious improvement was observed in either of the patient after more than 10 sessions(12 sessions in 1 case,and 13 sessions in the other case)of treatments with Q-switched alexandrite(755 nm)or Q-switched Nd:YAG laser(1064 nm).The immediate response of lesions to laser irradiation was unusual.Purpura or errhysis was absent in the lesions after repetitive irradiation with high-energy laser,but both were visible in the adjacent normal skin even after irradiation with low-energy laser.