Objective To investigate CT and MRI features of giant cell tumor of the skull.Methods CT and MRI features of 5 patients with giant cell tumor of the skull with histopathologically confirmed were analyzed retrospectively.Plain CT scanning was performed in all 5 patients.Plain MRI,contrast-enhanced MRI and HRCT scanning with facial nerve and auditory ossicle chain computer reconstruction were performed in 3 patients with giant cell tumor of temporal bone.Results Tumor occured unilateral in all cases,4 cases on the right side,1 case on the left side.CT scan showed a wide range of expanding destruction without sclerotic border,residual bone septum and bone cladding, On MRI, tumor signal variable;tumor appeared hypo-isointense on T1WI and heterogeneous hyperintense with hypointense rim on T2WI.CE-MRI: solid part of tumor show heterogeneous enhancement.Conclusion CT features of giant cell tumors of the skull was wide range of expanding destruction, residual bone septum and bone cladding.On T2WI, low signal in the rim of tumor was the disease characteristic imaging finding;Auditory ossicle chain and facial nerve CPR reconstruction made prepare for preoperative evaluation of otosteon and facial nerve,to provide more accurate image information for clinical treatment strategies.

Objective To compare the clinical response with etoricoxib 60 mg once daily with diclofenac sodium tablet 75 mg two times daily in the treatment of osteoarthritis of the knee or hip joint.Methods A 4-week multicenter,randomized,double-blinded and active comparator-controlled clinical trial was performed during January 2005 and June 2005 in 6 medical centers in China.Eligible patients (≥40 years old Chinese patients with osteoarthritis of the knee and hip) were randomized (1:1 ratio) to receive etoricoxib 60 mg once daily (n=90),or diclofenac sodium 75 mg twice daily (n=90).Primary efficacy end point is the change of WOMAC (Western Ontario and McMaster Universities osteoarthritis index) pain subscale from baseline to 4 weeks; non-inferiority bounds were pre-defined [if the upper bound of 95％ confidence interval (CI) for the difference is less than 10 mm on a 100-mm VAS WOMAC pain subscale] for the comparison of the change between the two groups.The secondary efficacy endpoints include WOMAC physical function subscale,WOMAC stiffness subscale,patient's global assessment of response to therapy (PGART),investigator's global assessment of disease status (IGADS),discontinuation due to lack of efficacy and rescue paracetamol tablet count.Safety was assessed by physical examination,adverse experience reported,and laboratory safety data.Results C6mpared to baseline,the changes of WOMAC pain subscale after 4 weeks treatment were statistically significant (P＜0.01) in both groups (etoricoxib group:51±16 vs 21± 19; diclofenac sodium group:53±16 vs 22±19).There was no difference in the change of WOMAC pain subscale between the two groups.The change in WOMAC stiffness subscale,WOMAC physical function subscale,PGART and IGADS in both groups were statistically significant (P＜0.01),but there was no difference between treatment groups according to the pre-defined non-inferiority criteria.No drug related serious adverse events were observed during the study.The difference in drug-related adverse event incidence between the two groups was not statistically significant.Etoricoxib and diclofenac sodium were generally safe and well tolerated.Conclusion Etoricoxib 60 mg administered once daily is efficacious and shows clinical efficacy notinferior to that of diclofenac sodium 75 mg administered twice daily for the treatment of osteoarthritis.Etoricoxib 60 mg administered once daily for 4 weeks is generally safe and well tolerated.

Objective To assess the effect of snapshot freeze (SSF) motion correction algorithm on the image quality of coronary CT angiography (CCTA).Methods Thirty-one consecutive patients underwent coronary CTA without heart rate control.All of the CCTA images were reconstructed by the means of both standard (STD) and SSF motion correction.Image quality and interpretability of STD and SSF reconstructions were compared.CCTA images were interpreted with Likert 4-points score system by two experienced radiologists.The image qualities were assessed on per-artery and per-segment level,and interpretability was performed on per-segment,per-artery,and per-patient levels.Comparisons of variables were performed with paired Wilcoxon rank sum test and paired Chi-square test.Results SSF reconstructions showed higher interpretability than STD reconstructions on per-patient [100.0％ (31/31) vs 64.5％ (20/31),x2 =9.09,P =0.002] and per-artery [100.0％ (124/124) v s 83.9％ (104/124),x2 =18.05,P =0.001] and per-segment level [99.0％ (413/417) vs 89.2％ (372/417),x2 =35.56,P =0.001].Image qualities were higher with the use of SSF than STD reconstructions on LAD [3.3 ± 0.7 vs 2.9 ± 1.0,Z =2.70,P=0.007],LCX [3.1 ±0.8 vs 2.5 ± 1.1,Z =3.23,P =0.001] and RCA [3.3 ±0.6 vs 2.1 ±0.9,Z =4.60,P =0.001],but they were similar on LM [3.9 ± 0.4 vs 3.7 ± 0.6,Z =1.89,P =0.059].Image quality was higher with the use of SSF versus STD reconstructions on per-segment [3.5 ± 0.7 vs 3.0 ± 1.0,Z =10.31,P =0.001] level.Conclusions The use of SSF motion correction algorithm improves image quality and interpretability of coronary CTA without heart rate control.

Vinflunine tartrate-loaded liposomes (VT-L) with two drug-to-lipid ratios were prepared by pH gradient method. Vesicle size and zeta potential were determined by the Zetasizer Nano ZS. Entrapment efficiency was evaluated by cation exchange resin centrifugalization method. The toxicity and tumor inhibition to nude mouse administrated by VT-L with different drug-to-lipid ratios were investigated and compared with the vinflunine tartrate injection (VT-I). The results showed that the mean particle size, zeta potential and entrapment efficiency of the VT-L with drug-to-lipid ratios of 1 : 5 and 1 : 10 were 124.6 nm and 128.3 nm, -25.3 mV and -22.8 mV, 94.46% and 97.31%, respectively. The VT-L with two different drug-to-lipid ratios has significantly higher anti-tumor effect to nude mouse transplanted human non-small cell lung carcinoma A549 and lower toxicity than VT-I. While there were no significant differences in anti-tumor effect and toxicity between VT-L with two different drug-to-lipid ratios.

OBJECTIVE: To analyze the correlated factors of cervical lymphatic metastasis of T3 and T4 glottic carcinoma. METHOD: We did a retrospective analysis of 91 glottic carcinoma patients' clinical data to analyze cervical lymph node metastasis on different T stage, pathologic degree and the tumor sites. RESULT: The cervical lymph node metastasis rate of 91 cases of T3 and T4 glottic carcinoma was 21.98%. T3 group's metastasis rate was 18.06% (13/72), T4 group's metastasis rate was 36.84% (7/19), P > 0.05. Grouped according to the degree of pathological differentiation, well-differentiated squamous cell carcinoma metastasis rate is 13.89% (5/36), middle-differentiated squamous cell carcinoma metastasis rate is 26.00% (13/50), and poorly-differentiated squamous cell carcinoma metastasis rate is 40.00% (2/5), P > 0.05. Cervical lymph node metastasis rate was 16.22%, when the tumor invading supraglottic region. Cervical lymph node metastasis rate was 15.38%, when the tumor invading subraglottic region. Cervical lymph node metastasis rate was 46.15%, when the tumor invading supraglottic and subraglottic region (P < 0.01). CONCLUSION Cervical lymph node metastasis in cN0 patient with supraglottic carcinoma is effected by T classification, cervical lymphatic metastasis of T3 and T4 glottic carcinoma is not entirely effected by T stage and pathologic degree. When the tumor invades supraglottic and subraglottic region, cervical lymph node metastasis is significantly higher. Therefore, the area of tumor invasion is an important factor for lymph node metastasis.
Humans ; Laryngeal Neoplasms ; pathology ; Lymph Nodes ; Lymphatic Metastasis ; Lymphatic Vessels ; Neck ; Neck Dissection ; Neoplasm Staging ; Retrospective Studies

Objective To investigate the relationship between abnormal metabolism of aggrecan and joint destruction in patients with rheumatoid arthritis (RA).Methods 140 RA patients with duration less than 24 months were enrolled into this study.The study also included 100 normal controls and 95 patients with other rheumatic diseases.Three monoclonal antibodies (5D4,7D4 and BC-3) of aggrecan were used to detected aggrecan catabolic fragments in serum of RA patients and the other two groups of controls by enzyme linked immunosorbent assay (ELISA),and the correlation of aggrecan catabolic fragments with joint damage were analyzed.Sharp evaluation of hand joints in RA patients were performed at baseline and after one year follow-up.Calculating the area under the receiver operating characteristic curve (ROC) was used to evaluate the sensitivity and specificity of aggrecan catabolic fragments detected in serum of RA patients.Results Both levels of 5D4 fragment and BC-3 fragment of RA group were higher than those of normal control [5D4 of RA:(5.8±2.1) ng/μl,normal control:(2.2±1.3) ng/μl;BC-3 of RA:(11.1±3.4) ng/μl,normal control:(5.0±2.1) ng/μl,F=38.65,24.07,P＜0.001).There was no difference in 7D4 fragment among three groups (F=0.589,P=0.478).Both two fragment levels of RA patients with anti-CCP positive were greater than those patients with anti-CCP negative [5D4:(5.6±1.3) ng/μl vs (4.4±1.1) ng/μl,F=21.23,P＜0.01;BC-3:(12.2±3.9) ng/μl vs (9.3±2.8) ng/μ1,F=27.14,P＜0.01].Linear Regression showed that serum fragments detected by 5D4 and BC-3,and anti-CCP positive were risk factors for Sharp deterioration after one year follow-up.The sensitivity and specificity of combined detection of two aggrecan fragments in serum of RA patients for the prediction of joint Sharp were 56.5％ and 84.2％ respectively.Positive predictive value and negative predictive value are 74.3％ and 70.6％.respectively.Application of areas of ROC to identify the best evaluation of Sharp was 0.798.Conclusion There is positive correlation between aggrecan catabolic fragments in serum and joint Sharp evaluation of RA patients.Detection of aggrecan catabolic fragments in RA patients may predict early joint destruction.

Objective To analyze age-related changes in fractional anisotropy(FA) in sub-regions of corpus callosum on diffusion tensor imaging(DTI).Methods DTI was obtained from 171 healthy individuals(80 men,91 women; age 12 to 73 years; median age 44 years).All the subjects were stratified into the following seven age groups(10-19,20-29,30-39,40-49,50-59,60-69,70-79 years).Corpus callosum was divided into 5 subregions(Ⅰ-Ⅴ region).DTI FA values of sub-regions of corpus callosum were measured.Mean FA values changes in corpus callosum sub-regions with advancing age were evaluated with hierarchical polynomial regression analyses.Results The mean FA value in the Ⅴ region was the highest within the same age group.The corresponding values from group 1 to 7 were 0.77±0.06,0.80±0.03,0.79±0.03,0.79±0.03,0.78±0.03,0.77±0.03,0.77±0.03,respectively.The mean FA value in the Ⅲ region was the lowest within the same age group.The corresponding values from group 1 to 7 were 0.51 ±0.08,0.59± 0.06,0.59±0.06,0.56±0.07,0.55±0.07,0.52±0.07,0.43±0.07,respectively.The change of FA values in subregions of the corpus callosum on DTI followed an inverted U-shaped curve with advancing age(ROI1-ROI5,R2=0.162,0.214,0.164,0.098,0.070,respectively,all P＜0.05).FA peak appeared at 20 to 30 years old in all regions.Conclusions The study demonstrated age-related changes in FA value in sub-regions of the corpus callosum on DTI as following a curve,reflecting the age-related changes of physiological processes,which could serve as a basis for corpus callosum research.

Three-way laryngeal mask airway (tLMA) was used in 31 patients aged 4-68 yr, weighing 10- 79 kg undergoing tracheal foreign body removal under general anesthesia. Anesthesia was induced with propofol 3 mg/kg, vecuronium 0.12 mg/kg and remifentanil 0.4 μg/kg. tLMA was inserted. The patients were mechanically ventilated. Anesthesia was maintained with iv infusion of propofol 2 mg . Kg-1 ? H-1, vecuronium 0.08 mg·kg-1·h-1 and remifentanil 0.15 μg·kg-1 ·min-1 . Radial artery was cannulated for BP monitoring and blood sampling. The operation time was 6-34 min and mechanical ventilation time 19-45 min. There was no significant change in SP, DP, HR, VT, Ppeak and Ppeak CO, during operation as compared with the baseline values before anesthesia. SpO2 was significantly increased at T2-6. PCO2, PO2 and O2sat were obviously improved after tLMA was used. All the patients emerged bom anesthesia within 30 min after operation. No aspiration, obvious gastrointestinal inflation, and pharyngeal and laryngeal edema and injury occurred. Mild agitation occurred in a short time during the recovery period in one patient. No complication occurred.

Objective To examine the benefits of ECMO for potential organ donors with hemodynamic instability after brain death.Methods Three brain-dead potential donors who presented with hemodynamic instability despite maximal medical management,finished a declaration of brain death,that were supported by extracorporeal circulation membrane oxygenation (ECMO).Results Donor organs,including six kidneys,and two livers,were harvested from the three donors under ECMO support,leading to 8 successful transplantations.The organs functioned well and the recipients made full recoveries.Conclusion Our experience indicates that ECMO allows for the maintenance of abdominal organ tissue perfusion without warm ischemia before organ procurement,providing sufficient time for safe organ donation procedures and reducing the risk of unpredictable cardiac arrest that could result in the donor death and graft loss.

Objective To compare the clinical efficacy of ibuprofen arginate,a new nonsteroidal antiinflammatory drug,with that of ibuprofen,in patients with rheumatoid arthritis or knee osteoarthritis and to evaluate the safety and tolerability of ibuprofen argihate.Methods This is a muhicenter,random,open,active comparator-controlled,parallel clinical trail in which 171 patients with rheumatoid arthritis or knee osteoarthritis were enrolled.Patients were randomized to 2 groups:400 mg of ibuprofen arginate three times daily and 400 mg of ibuprofen three times daily respectively.Clinical efficacy and safety were evaluated after 4-week treatment.Results Ibuprofen arginate,at dosages of 400 mg three times daily,had shown significant efficacy in relieving pain,tenderness and swelling of joints and there was no significant difference when compared to that of ibuprofen.There was no difference in clinical adverse effects between the two groups and no serious adverse effects were repofled.But ibuprofen arginate could initiate effectiveness more rapidly than ibuprofen in both rheumatoid arthritisand osteoarthritis patients.Conclusion Ibuprofen arginate has the same clinical efficacy and safety profiles as itmprofen in treating rheumatoid arthritis and osteoarthritis.However,its onset is more rapid than ibuprofen.