Objective To study the HRCT features of pneumatized inferior turbinate and to evaluate their diagnostic value.Methods Twelve cases of pneumatized inferior turbinates demonstrated by HRCT were retrospectively analyzed.Results Coronal HRCT could demonstrate pneumatization of the inferior turbinate clearly and directly.Unilateral pneumatization was found in 11 cases and bilateral in one case. According to the location of pneumatization,pneumatized inferior turbinates were classified into three types : bulbous,lamellar,and extensive types.Five of 12 cases were bulbous,5 were lamellar and 2 were extensive type.On coronal HRCT scans,bulbous type showed nodular shape in one case,oval and ellipse shape in 2 cases each,respectively.Lamellar pneumatization appeared as curved stripe-like shape in 4 cases communicating with the maxillary sinus and ellipse shape in one case.Extensive type was found in 2 cases, curled lamella-like shape was found in 1 case communicating with the maxillary sinus and ellipse shape in another case.In 5 cases with maxillary sinus communication,axial HRCT revealed a defect on the medial wall of the maxillary sinus.In such a condition,the maxillary process of palatine bone and maxillary bone attached to the lower turbinate separately.Conclusion HRCT was an optimal imaging modality for the diagnosis of pneumatization of the inferior turbinate and may help the clinicians to differentiate from other causes of the inferior turbinate hypertrophy.

Objective To study the CT and MRI findings of osteosarcoma in paranasal sinus and evaluate their clinical value.Methods All 9 cases of osteosarcoma were verified by histopathology.Imaging data were analyzed retrospectively.Results The lesion occurred in maxillary sinus in 5 cases,in ethmoid sinus in 3 cases and in sphenoid sinus in one case.Primary osteosarcoma was found in 7 cases.Secondary osteosarcoma occurred from fibrous dysplasia and ossifying fibroma each in one case.On CT,the involved areas revealed bony destruction associated with ill-defined and irregular soft tissue mass.The lesion showed heterogeneous density with minimal or massive tumor bone formation,cloud-like in 3 cases,ivory-like in 2 cases,spicule-like in 2 cases,cloud- and spicule -like in one case and spicule- and ivory-like in one case.Postcontrast CT showed mild to moderate inhomogeneous enhancement in 3 cases.On MR T_1 WI,the lesions showed hypointensity compared to brain in 5 cases and iso-intensity in 2 cases.On T_2WI,the lesions showed heterogeneous hyperintensity in 4 cases and isointensity in 3 cases with marked hypointense foci which corresponded to tumor bone on CT.Postcontrast MR imaging demonstrated moderate to marked inhomogeneous enhancement in these cases.MRI showed accurately the extent and associated changes of the lesions.The lesions invaded the orbit,pterygopalatine and infratemporal fossae,skull base and extensive craniofacial structures in 5,4,3 cases and 1 case,respectively.Conclusion CT is the optimal modality in showing tumor bone of osteosareoma in paranasal sinus.MRI can demonstrate optimally the invading extent of the lesions.Combined imaging modalities can provide more comprehensive information for diagnosis and therapy of osteosarcoma in paranasal sinus.

Objective To investigate the CT and MRI findings of cavernous hemangioma in paranasal sinus so as to promote the diagnostic accuracy.Methods All 30 cases of cavernous hemangioma in paranasal sinus were verified with pathological examinations.The CT and MRI findings were analyzed retrospectively.Results The lesions occurred in the maxillary sinus in 25 cases,in the anterior ethmoid sinus in 3 cases and in the sphenoid sinus in 2 cases.The lesions extended and compressed adjacent structures.MRI showed the extent and the associated changes of the lesions more clearly compared to CT. On CT,all the involved paranasal sinuses invariably expanded.The bony walls of paranasal sinuses were compressed and remodeled with focal defect in 28 cases,mostly in the medial wall of the maxillary sinus (21 cases).Bony scelerosis of the residual walls of paranasal sinus were found in 8 cases.The lesions demonstrated well-defined margin and heterogeneous density with phlebolith in 10 cases.Postcontrast CT showed marked inhomogeneous enhancement in 16 cases.On MR T_1WI,canernous hemangioma showed hypointense signal compared to brain in 4 cases and isointense signal in 14 cases.On T_2WI,the lesions revealed heterogeneous hyperintense singal in 16 cases and isointense signal in 2 cases with multiple hypointense foci.Postcontrast MR imaging demonstrated marked inhomogeneous enhancement in these cases,honeycomb-like appearance in 8 cases and variegated appearance in 10 cases.The feature of progressive enhancement was found on dynamic contrast enhancement of MRI in 8 cases.Conclusions The characteristic bony change together with phlebolith can suggest the diagnosis of cavernous hemangioma in paranasal sinus on CT.The heterogeneous hyperintense singal on MR T_2WI,progressive enhancement and honeycomb-like or variegated appearance on postcontrast MRI were also the characteristic findings of cavernous hemangioma in paranasal sinus.Combination of CT and MRI findings can provide more accurate information for the diagnosis and therapy of cavernous hemangioma in paranasal sinus.

OBJECTIVETo explore the mechanism of Chinese medicinal therapy for nourishing blood and softening Gan in treating senile pruritus through observing the impact of Guishen Zhiyang Recipe (GZR) on serum levels of stem cell factor (SCF) and dynorphin (DYN) in patients suffered from the disease of blood-deficiency and Gan-hyperactive syndrome type (BDGH).

METHODSSixty patients with senile pruritus were equally randomized into two groups, the patients in the treated group (33 cases) were treated by GZR, and those in the control group (28 cases) were treated by Fuyang Granule, all for 8 weeks. Changes of symptoms and skin lesions as well as blood levels of SCF and DYN were observed before and after treatment.

RESULTSThree patients were rejected from the treated group. Twenty patients in the treated group were cured after treatment, the cure rate being 66.7%, which was significantly higher than that in the control group (10 patients, 35.7%, P < 0.05). Levels of SCF and DYN in the treated group significantly lowered after treatment (all P < 0.01), and were lower than those in the control group (P < 0.05 and P < 0.01, respectively).

CONCLUSIONGZR shows favorite effect in treating senile pruritus of BDGH type and it may be achieved by regulating SCF and DYN levels to improve the pruritus associated inflammatory media.

Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Dynorphins ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Pruritus ; drug therapy ; metabolism ; Stem Cell Factor ; metabolism ; Syndrome

This study was purpose to investigate the frequency of HLA-DRB1*15 expression in children with aplastic anemia (AA) and its relation to effect of immunosuppressive therapy. HLA-DR genotypes were detected by SSP-PCR in 40 patients with acquired aplastic anemia and 107 normal controls, and the expressions of HLA-DR gene in AA patients and normal controls were compared. 32 out of 40 patients were treated with immunosuppressive therapy, which included antilymphocyte globulin combining with cyclosporine or cyclosporine alone, the relation of HLA-DRB1*15 expression to efficacy of immunosuppressive therapy and relapse of AA was explored. The results showed that the mean age of the patients was 9.0 years with a ratio of male to female 1.5:1. The frequency of HLA-DRB1*15 genotype expression in patients with idiopathic aplastic anemia was 51.5% (17/33), which was markedly higher than that of healthy controls (20.6%, p<0.01). All of 7 patients with second acquired aplastic anemia showed negative expression of HLA-DRB1*15. The rates of all responses, including complete remission and partial remission (CR+PR), and CR to immunosuppressive therapy in 16 patients who bared HLA-DRB1*15 were 93.8% and 87.5% respectively, which were higher significantly than those of patients without bearing HLA-DRB1*15 (56.3% and 31.3%, p<0.01). Relapse occurred in 5 patients who bared HLA-DRB1*15 genotype. It is concluded that the frequency of HLA-DRB1*15 genotype expression in children with AA is significantly higher than that in normal controls, and the immunosuppressive therapy for patients bared HLA-DRB1*15 shows favourable effect with high incidence of complete remission.
Adolescent ; Anemia, Aplastic ; drug therapy ; genetics ; immunology ; Antilymphocyte Serum ; therapeutic use ; Child ; Child, Preschool ; Cyclosporine ; therapeutic use ; Female ; Genotype ; HLA-DR Antigens ; metabolism ; HLA-DRB1 Chains ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male

BACKGROUNDNeovascular glaucoma (NVG) is a refractory disease which is difficult to manage. This study aimed at evaluating the efficacy and safety of adjunctive intravitreal bevacizumab (IVB) injection in conjunction with Ahmed glaucoma valve implantation (AGVI) in the management of NVG.

METHODSThis was a retrospective study of patients with NVG in whom AGVI was performed between October 2008 and May 2012. The sample was divided into two groups according to the pretreatment: with adjunctive IVB injection (the IVB group, n = 25 eyes) and without adjunctive IVB injection (the control group, n = 28 eyes). The surgical success rate, number of antiglaucoma medications used, best-corrected visual acuity (BCVA), postoperative complications, regression, and recurrence of iris neovascularization (NVI) were analyzed between the groups.

RESULTSThe surgical outcomes of the two groups were compared. The complete success rates in the IVB and control groups were 84.0% and 64.3% at 12 months and 80.0% and 53.6% at 18 months, respectively. There was a significant difference between the two groups (P = 0.041). Mean postoperative intraocular pressures, mean number of postoperative antiglaucoma medications, and BCVA were not significant between the two groups. The NVI in 22 (88.0%) eyes had completely regressed within 2 - 8 days after IVB. However, NVI recurred in 10 eyes (40.0%) 2 - 9 months later after IVB. The IVB group had only 1 case (4.0%) of hyphema out of 25 eyes, while there were 8 (28.6%) cases of hyphema out of 28 eyes in the control group (P = 0.026).

CONCLUSIONSThis study showed that preoperative IVB injection reduced NVI remarkably, decreased hyphema, and led to higher surgical success rates. Pre-operative IVB injection may be an effective adjunct to AGVI in the management of NVG.

Adult ; Aged ; Angiogenesis Inhibitors ; administration & dosage ; Antibodies, Monoclonal, Humanized ; administration & dosage ; Bevacizumab ; Female ; Glaucoma Drainage Implants ; adverse effects ; Glaucoma, Neovascular ; therapy ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Male ; Middle Aged ; Prosthesis Implantation ; methods ; Retrospective Studies ; Visual Acuity

The aim of this study is to synthesize the ordered mesoporous silica (OMS) as drug carrier to improve release property of insoluble drug and investigate the dissolution profile of insoluble drug from the porous carrier. The OMS was obtained by using cetyltrimethyl ammonium bromide as the template and resveratrol was selected as the model drug. The resveratrol-loaded OMS (Res-OMS) were characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), N2 adsorption-desorption, X-ray diffraction (XRD) and FT-IR spectroscopy. In vitro drug release behavior was also investigated. It was found that the synthesized OMS showed a large surface area, a narrow pore size distribution and an important mesoporosity associated to hexagonally organized channels. Compared with physical mixture and crystalline powder, resveratrol was in amorphous or molecular form after loading into OMS. The release rate ofresveratrol from drug-loaded OMS was significantly increased suggesting the great potential application of OMS for the formulation of poorly soluble drugs.
Drug Carriers ; Drug Compounding ; Drug Delivery Systems ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Porosity ; Silicon Dioxide ; chemistry ; Solubility ; Spectroscopy, Fourier Transform Infrared ; Stilbenes ; administration & dosage ; chemistry ; X-Ray Diffraction

【Objective】To evaluate the feasibility of magnetization transfer（MT）magnetic resonance（MR）imaging for predicting the risk of intestinal fistula in patients with Crohn disease （CD）. 【Methods】 The study prospectively enrolled 12 consecutive patients with CD and abdominal MT imaging were performed before elective surgery. The bowel wall MT ratio normalized to skeletal muscle was calculated；region- by- region correlations with the surgical specimen were performed. Histopathologic evaluation of fibrosis was executed by using Masson trichrome. Wilcoxon rank test ， Spearman rank correlation， and receiver operating characteristic curve （ROC） were used for statistical analysis.【Results】Among 15 surgical intestinal segments from 12 patients，5 lesions were found with intestinal fistula and of them 12 bowel specimens were obtained. The other 10 intestinal segments were without complications and 23 bowel specimens were enrolled. The intestinal fistula bowel showed a significant higher （P=0.045） normalized MT ratio. ROC analysis revealed an area under the curve of 0.674（95%CI：0.537-0.811）for differentiating intestinal fistula bowel from the non- fistula one. The sensitivity，specificity was 93.3% and 51.1% with a cut-off value of 76.8%，respectively. For the Masson score，significant difference（P=0.012）was found between the complicated intestinal specimens and the non-complicated ones. Additionally， the normalized MT ration was statistical correlated with Masson score （r=0.708，P<0.001）.【Conclusion】MT imaging could be a potential method to predict the risk of intestinal fistula in patients with CD.

Adult ; Aged ; Colectomy ; methods ; Colonic Neoplasms ; pathology ; surgery ; Duodenum ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Pancreas ; pathology ; surgery ; Pancreaticoduodenectomy ; Postoperative Care

OBJECTIVEA retrospective analysis of 160 pre-menopausal breast cancer patients was carried out to elucidate the the menstrual outcome in those cases who had undergone adjuvant chemotherapy after surgery, and evaluate the relationship between chemotherapy-induced amenorrhea (CIA) and recurrence of the disease.

METHODS160 pre-menopausal breast cancer patients were collected, 62/159 (39.0%) of them were node positive, 91/158 (57.6%) were ER positive, and 95/155 (61.3%) were PR positive. 111 cases had infiltrative ductal carcinoma, 26 cases had infiltrative lobular carcinoma, and 22 cases with others. In 152 cases data were collected by face-to-face interview and 8 cases by phone conversation. Types and cycles of chemotherapy regimen as well as menstrual abnormalities were recorded before, during, and after chemotherapy completion. Follow up duration was 12-72 months after chemotherapy completion for all patients.

RESULTS107 (66.9%) developed CIA, 24 cases returned to normal menses (22.4%), 83 cases continued CIA during more than 12-month follow up (77.6%). The rate of CIA increased with age (P < 0.01). During the follow up, disease free survival (DFS) rate was 85.9% in CIA group and 79.2% in non-CIA group, with no statistically significant difference. But in hormonal receptor positive patients, DFS was 80.0% in non-CIA and 90.1% in CIA, respectively (P = 0.04), showing a significant difference. Because of the small number of died cases, no analysis of the overall outcome was carried out.

CONCLUSIONAdjuvant chemotherapy causes ovarian function suppression, and may further leading to amenorrhoea. Women who experienced amenorrhoea after chemotherapy had a significantly better disease-free survival (DFS) rate showed by univariate analysis than women who continued normal menstruation. Chemotherapy is insufficient therapy for very young patients who are in high risk with hormone responsive disease, particularly when chemotherapy fails to induce amenorrhea. Further research is needed to evaluate interventional chemotherapy to improve the quality of life in women with early stage breast cancer who experienced ovarian toxicity. The post-chemotherapy menstruation status is a clinically valuable, objective and salient marker for sufficient endocrine effect of chemotherapy in ER/PR-positive premenopausal patients.

Adult ; Age Factors ; Amenorrhea ; blood ; chemically induced ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Breast Neoplasms ; drug therapy ; surgery ; Carcinoma, Ductal, Breast ; drug therapy ; surgery ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Follow-Up Studies ; Humans ; Middle Aged ; Premenopause ; Retrospective Studies