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Childhood cerebral palsy is one of the main causes leading to disability in children,at present the specific treatments are lacking.As a traditional Chinese medicine treatment method,Acupuncture and moxibustion have been paid more and more attention in recent years because of its unique therapeutic effect.This paper reviews various methods of acupuncture and moxibustion treatment for cerebral palsy,and analyzes the commonalities and characteristics of these methods in depth.At the same time,this article discusses the influential factors and mechanism of acupuncture and moxibustion treatment of cerebral palsy,pointing out the questions and challenges in the field of acupuncture and moxibustion treatment of cerebral palsy.In order to better promote the study of acupuncture and moxibustion treatment of cerebral palsy,it is necessary to fur-ther strengthen the standardization of treatment methods and mechanism research in the future.
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Objective:To investigate the effect of adjusting density exposure steps on image quality and radiation dose in digital mammography.Methods:Using the automatic exposure control (AEC) mode of the digital mammography machine, five different gland thicknesses of 4.3, 5.3, 6.3, 7.3, and 8.3 cm were simulated by attaching 0, 1, 2, 3, and 4 PMMA plexiglass plates under the RMI-156 modal body, and the density exposure steps were adjusted to -3, -2, -1, 0, 1, 2, 3, and 4 for each thickness. The target/filter combination, tube voltage, tube current, incident body surface dose (ESD), incident surface air kerma (ESAK), half-value layer (HVL) and the average glandular dose displayed by the device (displayed AGD) were recorded at each step and thickness, and the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), figure of merit (FOM) and the calculated average glandular dose (calculated AGD) were calculated. Then, the display effects of simulated fibers, simulated calcifications and simulated masses within the modal body were scored subjectively, and the changes in image quality and radiation dose at different steps were analyzed, and the relationships between ESD and ESAK, displayed AGD and calculated AGD, and displayed AGD/ESD and calculated AGD/ESAK were analyzed. A linear fit was used for the steps with SNR, CNR, and FOM, and an exponential function curve fit was used for the steps with mAs, ESAK, and calculated AGD. The differences between ESD and ESAK, displayed AGD and calculated AGD, and displayed AGD/ESD and calculated AGD/ESAK were analyzed by paired-samples t test. Results:The CNR and SNR of mammographic images rose and fell by about 8% with each increase or decrease of one step. The scores of image simulated fibers, simulated calcifications, and simulated masses showed an overall upward trend with increasing steps, but there were still cases where the scores decreased with increasing grades. FOM varied from 97% to 104% at each grade with little variability. ESD, ESAK, displayed AGD, and calculated AGD, which could measure radiation dose, showed an exponential trend of increasing function with increasing steps, with a variation of about 63% to 165%. There were statistically significant differences ( t=-9.61, P=0.001) between ESD (15.14±10.08) and ESAK (16.66±11.07). However, there were no statistically significant differences ( t=1.20, P=0.240) between displayed AGD and calculated AGD, which were 3.66±2.18 and 3.61±1.99, respectively. Conclusions:The adjustment of density exposure steps can make the image quality change linearly and the radiation dose change exponentially with increasing speed, and the mode and magnitude of the adjustment are appropriately stable with high application value.
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Objective:To study the effects of radiotherapy and the prognostic factors in hepatocellular cancer (HCC) patients with cardiophrenic angle or superior diaphragmatic lymph nodes metastasis (LNM).Methods:We retrospectively analyzed 56 HCC patients with cardiophrenic angle or superior diaphragmatic LNM who were treated with or without external beam radiation therapy (EBRT) in Zhongshan Hospital of Fudan University from Jan 2010 to Aug 2020. Patients were divided into two groups according to whether they received radiotherapy, EBRT group and non-EBRT group, and each group had 28 patients. Radiation fields included or excluded primary tumor in EBRT group, and the cardiophrenic angle or superior diaphragmatic LNM did not receive any local treatment in non-EBRT group. The response rate, survival rate, local control rate, prognostic risk factors of the two groups were studied.Results:After EBRT, the partial response rate and complete response rate were 32.1%(9/28) and 32.1%(9/28). The median survival rate of EBRT group was 16.1 months (95% CI 9.00-23.21, RR=3.63) vs. 6.9 months (95% CI 4.63-8.77, RR=1.06) for the non-EBRT group, with statistically significant difference ( χ2=15.53, P<0.05). Cardiophrenic angle or superior diaphragmatic lymph nodes 1-year local control rate for EBRT group and non-EBRT group were 37.0% vs. 10.7%, with statistically significant difference ( χ2=5.28, P<0.05). Since diagnosis of cardiophrenic angle or superior diaphragmatic LNM, 4 patients (14.3%) in the EBRT group vs. 13 patients (46.4%) in the non-EBRT group had higher alpha-fetoprotein (AFP) level after 3 months compared with the AFP before EBRT ( χ2=6.84, P<0.05). Multivariate analysis showed that multiple intrahepatic tumors, maximal diameter of intrahepatic tumors >5 cm, AFP≥400 μg/L, no EBRT were poor prognostic factors. Conclusions:EBRT can prolong overall survival and improve the control rate of lymph node of HCC patients with cardiophrenic angle or superior diaphragmatic LNM. Patients with multiple intrahepatic tumors, maximal diameter of intrahepatic tumors >5 cm, AFP≥400 μg/L and no EBRT have poor prognosis.
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Objective To investigate the inhibitory effect and mechanism of Metformin (Met) combined with irradiation in CT26WT cell lines or mouse models with transplanted tumors.Methods CT26WT cell line was treated with 0.5 μmol/L,1.0 μmol/L,5.0 μmol/L and 10.0 μmol/L Met,and CellTiter Glo kit was used to detect the inhibitory effect of Met at different concentrations on the viability of CT26WT cells.CT26WT cell line was treated with the control,Met (10 pmol/L),15 Gy irradiation and 15 Gy irradiation+Met (10 μmol/L).Clone formation assay was employed to detect the cell proliferation activity.Bablc mouse models of transplanted tumors (tumor size＞ 150 mm3) were established and randomly divided into the control,15 Gy irradiation,Met and 15Gy irradiation+Met groups.Mice were given with 750 mg/kg Met at 24 h before irradiation.Transplanted tumor volume was measured regularly to delineate the growth curve of transplanted tumors and survival curve.The expression levels of P-H2AX and Sting proteins in CT26WT cells and transplanted tumors were detected by Western blot.The infiltration of CD8a (+) T cells in transplanted tumor tissues was detected by immunohistochemistry.Results The relative cell survival rate was 100％,87.9％,87.8％,87.3％ and 76.5％ in the 0,0.5,1.0,5.0 and 10.0μmol/L Met groups,respectively (all P＜0.05).The inhibitory effect of 10.0 μmol/L was significantly stronger than that of 5.0 μmol/L (P＜0.001).The colone formation rate 34.0％,24.0％,22.3％ and 14.0％ in the control,Met,15 Gy irradiation,Met+ 15Gy irradiation groups,respectively (all P＜0.001).Western blot showed that compared with the control group,the expression of Sting protein was increased by 2.99-fold after Met treatment (P＜0.001),and increased by 1.37-fold and 4.41-fold in the 15 Gy irradiation and 15Gy irradiation+Met groups (both P＜0.01).Compared with the 15 Gy irradiation group,the expression of P-H2AX protein was significantly increased by 1.43 times after treatment with 15Gy+Met (P＜0.001).The transplanted tumor growth curve showed that the transplanted tumor growth in the 15 Gy+Met group was slower than that in the control group[(1007.0± 388.5) mm3 vs.(2639.0± 242.9) mm3,P＜ 0.05)].The overall survival time in the 15 Gy irradiation+Met group was 48 d,significantly longer than 32 d in the control group (P＜0.001).Compared with the control group,the expression of P-H2AX and Sting proteins in the 15 Gy+ Met group was increased by 8.8-fold and 1.6-fold (both P＜0.001).Immunohistochemical staining showed that the infiltration of CD8a (+) T cells in the 15 Gy irradiation+Met group was significantly higher than that in the control group (P＜0.01).Conclusions Met combined with radiotherapy can inhibit the proliferation and clone formation of colon cancer cells,probably by aggravating DNA damage and activating the Sting signaling pathway,eventually leading to the increase of CD8a (+) T cells in tumor tissues and enhancing the killing effect upon transplanted tumor cells.
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BACKGROUND: It is seldom reported that the effect of chemical acellular nerve allograft combined with bone marrow mesenchymal stem cell transplantation on sciatic nerve injury is evaluated by tensile mechanical properties. OBJECTIVE: To determine the effect of chemical acellular nerve allograft combined with bone marrow mesenchymal stem cell transplantation in the treatment of sciatic nerve injury. METHODS: Forty-five Sprague-Dawley rats were randomly divided into autologous nerve transplantation group, chemical acellular nerve allograft group, and chemical acellular nerve allograft and bone marrow mesenchymal stem cell transplantation group (n=15 per group). Models of 10-mm sciatic nerve injury were prepared. The injured sciatic nerves were repaired using autologous nerve, chemical acellular nerve allograft and chemical acellular nerve allograft and bone marrow mesenchymal stem cells. At 20 weeks after surgery, electrophysiological measurement and stretching experiments were carried out. RESULTS AND CONCLUSION: (1) The wave amplitude and motion conduction velocity were larger in the chemical acellular nerve allograft and bone marrow mesenchymal stem cell transplantation group and autologous nerve transplantation group than in the chemical acellular nerve allograft group (P < 0.05). (2) The tensile elastic limit strain, elastic limit stress, maximum strain and maximum stress were larger in the chemical acellular nerve allograft and bone marrow mesenchymal stem cell transplantation group and autologous nerve transplantation group than in the chemical acellular nerve allograft group (P < 0.05). (3) These results suggest that chemical acellular nerve allograft and bone marrow mesenchymal stem cell transplantation has obvious effect on repairing sciatic nerve injury.
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Ophthalmology rotation is an integral part of standardized training for general practitioners. The duration of ophthalmology training is only half a month in whole 33-month general practice residency training. The main objective of training for general practice residents is to master the basic clinical skills of ophthalmology, to be able to accurately and timely identify eye diseases, especially those requiring urgent treatment, and to prevent the loss of visual function. This article introduces our teaching experience in ophthalmology training for general practice residents accumulated since 2014. We suggest that the trainees should pre-examine patients independently, play a role of standard patients and receive consultation from teachers. We developed a simple patient assessment form for primary care doctors, the patient who got 10 or more points of the form, should be referred to ophthalmological specialists.
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Ophthalmology rotation is an integral part of standardized training for general practitioners. The duration of ophthalmology training is only half a month in whole 33-month general practice residency training. The main objective of training for general practice residents is to master the basic clinical skills of ophthalmology, to be able to accurately and timely identify eye diseases, especially those requiring urgent treatment, and to prevent the loss of visual function. This article introduces our teaching experience in ophthalmology training for general practice residents accumulated since 2014. We suggest that the trainees should pre-examine patients independently, play a role of standard patients and receive consultation from teachers. We developed a simple patient assessment form for primary care doctors, the patient who got 10 or more points of the form, should be referred to ophthalmological specialists.
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Objective To investigate the effects and mechanisms of Omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplementation on spatial learning and memory capacity,neuronal apoptosis,microglia activation,neuroinflammatory response and nuclear factor-κB (NF-κB) pathway in cognitive impairment model rats.Methods Cognitive impairment model rats were induced by intraperitoneal injection of D-galactose.Thirty-six Wistar rats were randomly divided into three groups:control group (Con),Cognitive impairment group (AD) and ω-3 PUFA supplementation group (AD+ω-3).The spatial learning and memory capacity of experimental rats were examined by the Morris water maze (MWM).Apoptotic neurons were determined by Nissl staining.The microglia activation relatived protein (Iba-1) expressions was determined by immunohistochemistry staining and western blot,respectively.While,the serum levels of tumor necrosis factor-α (TNF-α),interleukin (IL)-1 and IL-6 were tested by enzyme linked immunosorbent assay (ELISA).In addition,the protein expression of NF-κB related indexes including NF-κB p65,p-IκB and TLR4 were tested using western blot.Results Compared with the Con group,the escape latency increased and the distance percentage in target quadrant decreased;neurons apoptosis,microglia activation and neuroinflammatory factors significantly increased in the other two groups (P=0.00).Compared with the AD group,the escape latency was remarkably shorter (2 d:41.35±2.34vs.58.07±3.27,P=0.03;3 d:35.07±2.45 vs.44.39±3.21,P=0.02;4d:28.12±2.43vs.35.63±2.20,P=0.01;5 d:23.74±1.06 vs.29.76±1.15,P=0.03),and the distance percentage in target quadrant increased significantly [(48.26±4.02)％ vs.(34.14±3.49)％,P =0.01] after ω-3 PUFA supplementation.The incidence of neurons apoptosis significantly decreased in AD + ω-3 group [(29.93 ±3.05) ％ vs.(47.58±4.14)％,P=0.01].ω-3 PUFA supplementation inhibited the protein expression of microglia,and meanwhile inhibed the expression of microglia-induced neuroinflammatory factors [TNF-α:(85.27±9.77vs.156.13±14.53) pg/ml,P=0.00;IL-1:(41.23±5.38vs.75.04±9.27) pg/ml,P=0.01;IL-6:(47.58±4.23 vs.97.47±9.09) pg/ml,P=0.00].Compared with AD group,the protein expression of NF-κB pathway significantly decreased in AD+ω-3 group.Conclusion ω-3 PUFA supplementation can inhibited microglia activation,decrease microglia-mediated neuroinflammatory response,reduce neuron apoptosis and markedly improve spatial learning and memory capacity in cognitive impairment rats,possibly mediated by inhibiting NF-κB pathway.
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Objective@#To investigate the value of computed tomography (CT) texture analysis in differential diagnosis of inflammatory and malignant pulmonary nodules.@*Methods@#The image data of 54 patients with lung cancer and 36 patients with pulmonary inflammatory nodules were retrospectively collected in our hospital. All the patients received chest CT scan. CT texture analysis of entropy, correlation degree and contrast ratio were performed by the MaZda software. The receiver operating characteristic curve (ROC) was established and the area under the curve (AUC) was calculated to evaluate the value of CT texture analysis in differential diagnosis of inflammatory and malignant pulmonary nodules.@*Results@#In the lung cancer group, the value of entropy, correlation degree and contrast ratio were 1.58±0.07, 0.02±0.17 and 8.79±2.59, respectively. In the inflammatory nodules group, the value of entropy, correlation degree and contrast ratio were 1.51±0.04, 0.22±0.16 and 12.53±2.24, respectively. The differences were all statistically significant (P values were 0.008, 0.027, and 0.006, respectively) between two groups. There was not statistically significant difference (P>0.05) in the CT values between the lung cancer group and the inflammatory nodule group based on the non-contrast enhanced CT scan. Meanwhile, there was no statistically significant difference (P>0.05) in the value of entropy, correlation degree or contrast ratio between two groups based on arterial phase or venous phase of contrast enhanced CT. The ROC analysis showed that the AUC in differentiating the lung cancer and inflammatory nodules was 0.821, 0.778 and 0.875, respectively. The AUC of combination of three phases was 0.931, which was higher than the AUC of entropy, correlation degree and contrast ratio respectively (P<0.01). The sensitivity was 88.9%, and the specificity was 87.5%.@*Conclusion@#CT texture analysis is a high-potential image analysis method, which can provide more information for the differential diagnosis of benign and malignant pulmonary nodules.
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OBJECTIVE: To investigate the effects of Kangfuxin solution combined with Chuangyangling and gelatin sponge on dry socket disease in patients with type 2 diabetes mellitus after the extraction of impacted teeth. METHODS: A total of 85 patients with impacted teeth and type 2 diabetes mellitus during Jan. 2016-Jan. 2017 were divided into group A (29 cases), B (25 cases), C (31 cases) according to random number table. All patients were treated with turbine drill method; in group A, Kangfuxin solution + Absorbable gelatin sponge was used to fill the wound site; in group B, Chuangyangling+compound preparation of Kangfuxin solution and gelatin sponge were used to fill the wound site; in group C, the wounds were filled with gauze but without any drugs. All patients received routine anti-infective treatment after surgery for 5-7 d. The time of impacted teeth extraction was observed in 3 groups; granulation tissue coverage integrity rate of tooth socket and the incidence of dry socket disease 7 d after surgery, the incidence of other postoperative complications, treatment cost, satisfaction scores were also comparod. RESULTS: There was no statistical significance in the time of impacted teeth extraction or treatment cost among 3 groups (P＞0. 05). Seven days after surgery, granulation tissue coverage integrity of tooth socket and satisfaction scores were in descending order: group B＞group A＞group C; the incidence of dry sockets were in ascending order: group B＜group A＜group C, with statistical significance (P＜0. 05). The incidence of other postoperative complications as bleeding, pain, swelling, limitation of mouth opening in group A and B were significantly lower than group C, with statistical significance (尸＜0. 05). There were no statistical significance between group A and B (P＞0. 05). CONCLUSIONS: Kangfuxin solution combined with Chuangyangling and gelatin sponge can effectively increase granulation tissue coverage integrity of tooth socket, and reduce the incidence of dry socket disease and other postoperative complications in patients with type 2 diabetes mellitus, but do not increase economic burden of patients and obtain high patient satisfaction.
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OBJECTIVE: To observe the clinical efficacy and safety of additional use of Cypate gingival fluid in periodontal basic therapy before surgery in the treatment of pregnancy gingival tumor. METHODS: A total of 86 patients with pregnancy gingival tumor in Second Affiliated Hospital of Qiqihar Medical University during Jan. 2015 to Jan. 2016 were divided into observation group and control group according to random number table, with 43 cases in each group. Control group received ligation and oral micro-electrosurgical surgery according to the volume of tumor. Observation group was given Cypate gingival fluid-based periodontal basic therapy (3-5 mL for gargling, 2-3 min each time, 3-5 times each day, 5 d) and then receive surgery. Clinical efficacies, gingival related indexes (gingival index, sulcular bleeding index, probing depth), quality scores of life, ADR, the occurrence of complications were observed in 2 groups. The followed-up was conducted 1 year after surgery, and the recurrence of gingival tumor was compared between 2 groups. RESULTS: No case was found shedding in the study. The total response rate of observation group was 97. 67％, which was significantly higher than 79. 07％ of control group (P＜0. 05). After treatment, the gingival related indexes of 2 groups were decreased significantly compared to before treatment, while quality scores of life were increased significantly compared to before treatment, observation group was significantly better than control group (P＜0. 05). No severe ADR or complication was found in 2 groups during treatment. Recurrence rate of gingival tumor in observation group was 2. 33％, which was significantly lower than 13. 95％ in control group 1 year after treatment (P＜0. 05). CONCLUSIONS: Compared with surgery alone, additional use of Cypate gingival fluid in periodontal basic therapy before surgery has better clinical efficacy and lower recurrence rate, with good safety.
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Objective To study the estimated value of general pituitary hormone levels and "overall levels of pituitary hormone" in patients with pituitary adenoma.Methods Sixty-six patients presented with non-function pituitary adenomas,admitted to our hospital from January 2009 and April 2013,were chosen in our study.Pre-and post-operative hormonal levels and MR imaging data were collected.Patients were divided into two groups:macroadenoma (1 cm＜diameter＜3 cm) group and huge adenoma (diameter＞3 cm) group,and the patients were divided into subtotal resection group (resection rate＞60％) and partial resection group (resection rate＜60％).Self-made scale of "overall levels of pituitary hormone" was performed to assess the remnant pituitary function.The levels for 6 kinds of pituitary hormones and "overall levels of pituitary hormone" were compared between each two groups.Results (1) The levels of 6 kinds of pituitary hormones between the macroadenoma group (n=38) and huge adenoma group (n=28) showed no significant difference before surgery (P＞0.05);the per-operative "overall levels of pituitary hormone" were statistically different between the macroadenoma group (19.59±2.71) and huge adenoma group (18.07±2.00,P＜0.055);there were 13 patients (34.2％) from macroadenoma group and 17 (60.7％) from huge adenoma group having one or more kinds of pituitary hormones lower than normal levels,with significant difference (P＜0.05).(2) The levels of 6 kinds of pituitary hormones between subtotal resection group (n=57) and partial resection group (n=9) showed no significant difference after surgery (P＞0.05);the post-operative "overall levels of pituitary hormone" in the subtotal resection group were significantly higher than those in the partial resection group (P＜0.05);there were 34 patients (59.6％) from subtotal resection group and 2 (22.2％) from partial resection group having one or more kinds of pituitary hormones lower than normal levels,without significant difference (P＜0.05).Conclusions The "overall levels of pituitary hormone",in which 6 kinds of pituitary hormones are seen as a whole,can assess the remnant pituitary function in pituitary adenoma patients more accurately than evaluation of the 6 kinds of pituitary hormone levels separately.
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Rathke's Cleft Cyst is a common benign pituitary lesion.Its common clinical signs include headache,visual disturbance and pituitary dysfunction.Progressive cysts can be found in some cases,and diabetes insipidus in a few.MRI is the most valuable imageological examination for these lesions.Transsphenoidal surgery is suitable for a proportion of the patients while follow-up observation is proper for most of the patients.
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Portal vein invasion (PVI) is common in hepatocellular carcinoma (HCC) and largely contributes to tumor recurrence after radical tumor resection or liver transplantation. Vasculogenic mimicry (VM) was an independent vascular system lined with tumor cells and associated with poor prognosis of HCC. The present study was conducted to evaluate the relationship between VM and portal vein invasion. A total of 44 HCC cases receiving anatomic liver resection were included in the study and were divided into groups with and without PVI. The prevalence of VM in each group was examined by CD34-PAS dual staining. The regulatory molecules of VM formation such as Notch1, Vimentin and matrix metalloproteinases (MMPs) were investigated by immunohistochemical staining. Analysis was performed to explore the association of PVI, VM and the VM regulatory molecules. PVI was found in 40.91% (18/44) cases and VM was found in 38.64% (17/44) cases in total samples. The incidence of VM was 72.22% (13/18) in PVI group while it was 15.38% (4/26) in non-PVI group (P<0.001), VM formation was positively correlated with PVI (r=0.574, P<0.001). The VM forming regulatory molecules such as Notch1, Vimentin, MMP-2 and MMP-9 were found to be correlated with PVI in HCC patients. Taken together, our results suggested that VM formation, alone with its regulatory molecules, is the promoting factor of PVI in hepatocellular carcinoma.
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Carcinoma, Hepatocellular/blood supply , Liver Neoplasms/blood supply , Portal Vein/pathology , Carcinoma, Hepatocellular/pathology , Female , Humans , Liver Neoplasms/pathology , Male , Middle Aged , Neovascularization, Pathologic/pathologyABSTRACT
Objective To explore the expression of endothelial cell specific molecule-1 (ESM-1) and its clinical significance in pituitary null cell adenoma (NCA).Methods Forty-six cases of NCA specimens,collected from resection of pituitary tumor via microscopic transsphenoidal approach in our hospital from January 2010 to May 2014,were chosen in our study;ESM-1 expressions in the NCA specimens was detected by immunohistochemical S-P method,and the relations of expression results with gender (male:29;female:17),age (18-45 years old:16;≥46 years old:30),maximum tumor diameter (1-3 cm:34;≥3 cm:11;＜1 cm:1),invasion state (invasive NCA:30;non-invasive NCA:16),Ki-67 labeling index (＜3％:29;≥3％:17) and pathological features were analyzed.Results ESM-1 expression was observed in endothelial cells and adenoma cells,with positive rates 100％ and 86.96％ (40/46);in the endothelial cells,high expression was noted in 32 patients;and in the adenoma cells,high expression was noted in 25 patients;no significant difference of high expression was noted between the two (P＞0.05).As compared with that ofnoninvasive NCA (7/16),the high expression of ESM-1 of invasive NCA (23/30) in endothelial cells was significantly increased (P＜0.05),while the high expression of ESM-1 in adenoma cells was not significantly increased (P＞0.05).In endothelial cells,high expression of ESM-1 was not significantly different in patients of different ages,gender,maximum tumor diameters or Ki-67 labeling indexes (P＞0.05);in adenoma cells,high expression of ESM-1 was not significantly different in patients of different ages,gender,maximum tumor diameters,Ki-67 labeling indexes or invasion states (P＞0.05).Conclusion ESM-1 in endothelial cells could be used as a marker of aggressive behavior in NCA.
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Objective To explore the effect of nonfunctioning pituitary adenoma (NFPA)apoplexy on growth rate of residual tumor after transsphenoidal operation.Methods The follow-up MR imaging data of 57 patients with NFPA who had residual tumors after transsphenoidal operation,admitted to our hospital from May 2005 to May 2015,were analyzed retrospectively.The tumor volume doubling time (TVDT) of residual tumors,rapid growth rate and apoplexy/tumor size ration were calculated.The relations of tumor rapid growth rate with existence of adenoma apoplexy,course of adenoma apoplexy and apoplexy/tumor size ration were compared.Results There were 30 patients with NFPA apoplexy and 27 without adenoma apoplexy.Postoperative follow-up indicated enlarged residual tumors in 49 patients,and shrank ones in 8 patients.The mean TVDT was (1305.82±1685.32) d.The rapid growth rate of residual tumors in NFPA apoplexy group (56.67％) was not significantly increased as compared with that in non-NFPA apoplexy group (66.67％,P＞0.05).The rapid growth rate of subacute NFPA apoplexy group (81.82％) was significantly higher than that of chronic NFPA apoplexy group (36.84％,P＜0.05).The rapid growth rate of group of apoplexy/tumor size ration less than 12％ (40％) was not significantly different as compared with that of rapid growth rate of group of apoplexy/tumor size ration more than 12％ (66.67％,P＞0.05).Conclusions Adenoma apoplexy is one of the factors that affect the growth rote of residual tumors ofNFPA after transsphenoidal operation.For patients with NFPA apoplexy in subacute or chronic phase,if their symptoms are mild,they can be followed up regularly.
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Gelastic epilepsy is a special refractory epilepsy accompany with ictal laughing and/or crying which can be divided into cortical induced gelastic epilepsy and hypothalamic hamartomas induced gelastic epilepsy according to their epileptogenic focus.Currently, domestic scholars had lack of systematic understanding of the mechanism and clinical treatment involved in gelastic epilepsy.Recently, foreign scholars had achieved great progress in the research of gelastic epilepsy which included the ictal laughing mechanism in gelastic epilepsy, the primary molecular mechanism in hypothalamic hamartomas induced gelastic epilepsy, the secondary epileptogenesis mechanism in hypothalamic hamartomas induced gelastic epilepsy and the clinical treatment of gelastic epilepsy.Now, the study progress of pathogenesis and clinical treatment of gelastic epilepsy were reviewed.
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ObjectiveTo investigate the influence of concurrent human immunodeficiency virus (HIV) infection on antiviral therapy for hepatitis C virus (HCV) in patients with chronic hepatitis C. MethodsTwenty-eight patients with hepatitis C and concurrent HIV infection (HCV/HIV group) and 28 patients with pure HCV infection (HCV group) treated in Ruzhou People′s Hospital and the Sixth People′s Hospital of Zhengzhou from 2013 to 2014 were selected and treated with common interferon combined with ribavirin as anti-HCV therapy. HCV RNA viral load and blood routine were measured at weeks 0, 12, 24, and 48 of therapy and 24 weeks after therapy, and other adverse effects were recorded in detail. The t-test was applied for comparison of continuous data between groups, and chi-square test was applied for comparison of categorical data between groups. ResultsHCV RNA viral load was gradually reduced after antiviral treatment in both groups, and the two groups showed significant differences in sustained virologic response and end-of-treatment virologic response (χ2=6744 vs 5.622, P=0.013 vs 0.024). As for adverse effects, the two groups showed decreases in leukocyte count, with significant differences between the two groups at weeks 12, 24, and 48 of therapy (t=3.422, 4.443, and 2.949, all P＜0.01). The two groups showed no significant differences in platelet count, gastrointestinal symptoms, and flu-like symptoms (all P＞0.05). ConclusionConcurrent HIV infection has varying degrees of influence on anti-HCV virologic response and adverse effects in patients with chronic hepatitis C.
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Objective To investigate the value of dual-energy virtual unenhanced and dual-energy iodine value distribution diagram type of kidney cancer.Methods A retrospective analysis of 35 cases of renal cell carcinoma dual-energy CT scan data,compared to kidney pathology data,analyze the image quality and radiation dose dual-energy virtual unenhanced and dual energy distribution of iodine in clear cell carcinoma and non-clear cell carcinoma the differences that exist.Results Unenhanced and virtual unenhanced image quality was quite,CT value (routine unenhanced renal parenchyma 31.90±4.10 HU,abdominal aortic 45.60±6.30 HU,psoas 50.00±6.6 HU3,kidney 1.410±17.06 HU; virtual unenhanced renal parenchyma abdominal aortic 33.20±5.50 HU,48.30±8.00 HU,52.40±10.63 HU psoas kidney 0.87±17.48 HU),signal to noise ratio (routine unenhanced renal abdominal aorta 3.22±1.49,5.13±2.57,4.56±2.12 psoas kidney 3.24±2.27 virtual unenhanced renal abdominal aorta 2.73±1.08,3.79±1.64,3.23±1.35 psoas kidney 2.18± 1.57) had not significantly different (P ＞ 0.05).Clear cell carcinoma of the skin medullart junction of iodinedistribution of images Iodine (2.75±1.05) mg/ml was higher than non-clear cell carcinoma (1.25±0.72) mg/ml,the difference was statistically significant (t =7.048,P ＜ 0.05).Conclusions CT examination in patients with renal cell carcinoma virtual unenhanced image quality is similar with routine unenhanced image quality,it reduces radiation dose.The distribution of iodine can provide more diagnostic information that can help us be more intuitive and accurate judgments of the blood supply and kidney cancer subtypes.
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Objective To investigate the clinical applications of dual-source dual-energy CT and dual-energy virtual unenhanced iodine distribution technology in thoracic tumor scans.Methods CT and clinical data of 58 cases of patients with thorax tumor were analyzed.The quality score,the noise,the average lesion CT values and radiation dose were compared between dual-energy group virtual unenhanced and conventional unenhanced image.The lesion benign and malignant differential diagnosis by strengthen the distribution of iodine value in dual-energy group and strengthen the value of manual measurement in conventional CT group were compared.Results The quality scores in virtual unenhanced and conventional unenhanced image were (4.62±0.52) and (4.71±0.46) points (t =2.319,P ＞ 0.05).The noise in virtual unenhanced images and conventional unenhanced image were (8.10±1.16) and (7.30±1.06) HU (t =5.246,P＜ 0.05).The effective dose in virtual unenhanced and in conventional plain were (5.18±0.96) and (5.55±1.18) mSv (t =4.005,P ＜ 0.05).CT value distribution of iodine was correlated with enhanced CT values.Conclusions The virtual unenhanced images can show well lung disease,which meet the diagnostic requirements and may be instead of the conventional plain chest potential value.Dual-energy iodine distribution of lesions can observe blood supply more directly and more sensitively,can quantityze expression of the extent of the lesions enhanced to provide richer information for clinical diagnosis of tumor lesions.