Objective To evaluate the value of CT guided branchofiberoscopic biopsy of carcinoma originating from small bronchiole. Methods The fiberbronchoscopic biopsy results of 33 cases under CT guidance were compared to the results of surgical pathology, including fiberbronchoscopic blind examination and CT guided percutaneous lung biopsy. Results The lesions occurred in 1 - 3 grade bronchus could be approached with fiberbronchoscopic biopsy under direct vision. CT guided fiberbronchoscopic biopsy had the benefit of getting more reliable, accurate samples simultaneously with less complications in the diagnosis of bron-chiolar lesions. It was more easy and having higher positive rate to diagnose the lesion of terminal bronchiole and alveoli by CT guided percutaneous lung biopsy. Conclusions CT guided fiberbronchoscopic biopsy can collect more wholesome pathologic specimen than other examinations for small lesions of bronchus. The comprehensive utilization of microscopy, brush biopsy and multiple sites biopsy can improve the accuracy.

Adult ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurotoxicity Syndromes ; diagnosis ; Retrospective Studies ; Tomography, X-Ray Computed

Animals for model of osteoporosis involve rat, mouse, rabbit, beagle dog, minipig, sheep, etc. The types of model include aged related model, ovariectomized model, orchietomied model, drug treated model, abolition degeneration model, and dietary bone loss. The rat with ovariectomized model is used widely. Biochemical determination, bone mineral density measurement, bone histomorphorphormetry and bone biomechanics are used to judge the formation of experimental osteoporosis.

Objective To explore the better diagnostic method for acute splenic arteral injury through comparative analysis of CT and DSA. Methods Fifty-seven patients with acute splenic injury were examined by CT and DSA,treated with splenic arterial embolization and then undertook follow up. Results CT examination possessed higher sensitivity and accuracy than DSA in demonstrating splenic parenchymal laceration,intrasplenic hematoma,subcapsuler hematoma,rupture of splenic capsule and combinated injury of intra-abdominal organs,especially in localizing splenic laceration.And there was a high significant difference statistically between the two kinds of examination(?~2=10.71,P

The latest literature concerning operative treatment for distal radius fracture was reviewed to find out the newest developments in this field.This paper summarizes bilateral internal fixation with combined palmar and dorsal incisions,dorsal open reduction and plate internal fixation,internal fixation with LCP(locking compression plate),dorsal Pi-plate internal fixation combined with external fixators,and arthroscopic treatment of distal radius fractures,for they are reported to have reached excellent or good results.The reports show that each subtype of distal radius fractures merits a unique approach,because distinct fracture patterns result from different mechanisms of injury.

Objective To evaluate the comprehensive application of the CT guided transbronchial lung biopsy (CT TBLB) and CT guided percutaneous needle lung biopsy (CT_NLB) in pulmonary peripheral lesions.Methods According to the lesion location in lung field,51 patients were selected to CT TBLB and 46 patients to CT NLB.Results In the comprehensive application of the two lung biopsy methods,the comphensive biopsy success rate was 100%,pathological diagnostic positive rate 87.6% and diagnostic correct rate 97.9% (of them 100% in CT TBLB).The complications of pneumothorax and haemoptysis were decreased significantly.The positive rate and diagnostic correct rate seem higher,but there was no significant difference between the two methods (P

Objective To investigate the histologic basis of imaging manifestations on adrenal myelolipoma and evaluate the value of various imaging modalities in diagnosing the tumor.Methods The imaging manifestations and pathological features of 21 cases of adrenal myelolipoma proved by postsurgical pathology were retrospectively analysed.Results Histologically,the myelolipoma presented hematopoietic elements amidst fatty tissue and showed indefinite border.The myeloid tissue was well vascularized and were adherent closely to normal adrenal gland.Both CT and MRI detected a single mass with irregular plaque or streak of bone marrow tissues between fatty components.The capsule of the tumor was not apparent,but rarely it presented an irregular local “capsule”which was composed of adrenal tissue with compression surrounding the tumor.Enhanced-scan found foggy enhancement in fatty tissue and enhancement of bone marrow tissue which made myeloid plaque enlarged and the edge misted.Ultrasonography demonstrated highly echogenic fat-containing ball of adrenal,while intravenous urography only showed translocation and renal axis alteration of homolateral kidney.Conclusion CT scan appears to be the most accurate qualitative modality to demonstrate adrenal myelolipoma while coronal and sagittal section scanning on MRI can make its localization more exact.Ultrasonography is also an important way in detecting the mass whereas intravenous urography and abdominal plain film should not be used to be the qualitative criterion.

BACKGROUND: It has been reported that a combination of estrogen and progestin has a protective synergistic effect on osteoporosis with only little side effects.OBJECTIVE: This study was designed to investigate the effect of a combination of norethisterone and ethinyl estradiol (EE) on bone mass in ovariectomized rats.DESIGN: This study was a randomized controlled experiment.SETTING:It was conducted at the Department of Pharmacology of Guangdong Medical University.MATERIALS: Twenty-four specific pathogen free (SPF) unmated SD rats were selected, aging 4 and half months and weighing 230±15 g.METHODS: The experiment was conducted in the Department of Pharmacology of Guangdong Medical College from May to November 2002.These rats were randomly divided into 3 groups: pseudo-operation group, ovariectomy group and compound norethisterone group, each containing 8 rats. For the former two groups, ethanol solution (volume fraction=0.056), at a dose of 5 mL/(kg.d), was administered by gavage. While for compound norethisterone group, 60μg/(kg·d) norethisterone and 3.5μg/(kg·d) EE were given by gavage (according to the dosage for human, which was 20-35 μg EE combined with norethisterone). Duration of treatment was 90 days for all the animals. Then their tibias were removed. Employing a fullyautomatic imaging analysis system, osteoclasts and the relevant dynamic and static parameters reflecting secondary trabeculaes formation region in proximal tibias were measured. Respectively, the humeral samples were removed and employing the palsma emission spectrograph of full-spectrum direct reading, calcium content and hydroxyproline content in bone samples were measured. Meanwhile, urine calcium and hydroxyproline concentrations were examined as well.MAIN OUTCOME MEASURES: ①The trabecular area (Th. Ar), trabecular thickness (TbkTh), trabecular number (Tb.N) and trabecular separation (Tb. Sp) and the changes in static parareters of perimeters of osteoclasts were investigated. Variance in percent labeled perimeter (L. Pm ％), mineral apposition rate (MAR) and bone formation rate (BFR/BV) were also calculated. ②Changes in serum alkaline phosphatase (AKP), calcium and hydroxyproline contents in bone and urine were all measured.RESULTS: All the 24 rats entered the analysis procedure. Compared to pseudo-operation group, for the ovariectomy group, Tb. Ar and Tb.N decreased, Tb. Sp increased and osteoclast perimeter significantly increased (P＜0.01). Addtionally, the bone formation markers increased apparently with an increase in L. Pm ％ and MAR (P＜0.05) and a significant increase in BFR/BV (P＜0.01). Compared with the ovariectomy group, for the compound norethisterone group,the bone mass and the Tb.N increased, marked by an increase of 82％ in Tb. Ar and an increase of 83％ in Tb.N (P＜0.05), and the Tb.Sp decreased, marked by a decrease of 51％ (P＜0.05). Meanwhile, there was a decrease of 52.5％ in osteoblast perimeter (P＜0.01), an increase in organic bone matrix and a decrease in urine hydroxyproline (P＜0.05).CONCLUSION: A combination of estrogen and progestin has a protective synergistic effect on ovariectomized rats with osteoporosis, and it is capable of increasing the organic bone matrix without significant inhibitory effects on bone formation. The experimental dosage of the compound was calculated according to the clinical dosage, 20-35 μg estrogen combined with a progestin, which will yield optimal protective effects on bone sometimes.

Objective To study the risk factors of MRI for the prediction of collapse in patients with avascular necrosis of the femoral head.Methods Twenty-two patients (39 hips) diagnosed avascular necrosis of femoral head by MR were enrolled in our study.The following MR appearances were evaluated:bone marrow edema,joint fluids,signal intensity and location of the lesion.The volume and surface area of the necrosis zone were calculated.The time of follow-up was 18-84 months (median,25 months).Logistic regression analysis was used to predict the risk factors by SPSS 13.0.The maximum value of Youden index was selected as the critical point to predict the collapse of femoral head and to define the sensitivity,specificity and accuracy.Results In the 39 hips with femoral head necrosis,21 hips had collapse.Bilateral collapse occurred in 5 cases.In 25 hips with the necrosis surface larger than 25％,collapse occurred in 21 (84％); In 8 hips with the volume of femoral head necrosis larger than 30％,collapse occurred in all cases; 1n 33 hips with the necrosis locating at the superolateral quadrant,collapse occurred in 21 (63.6％); In 22 hips with necrotic areas showing heterogeneous signal intensity,collapse occurred in 18(81.8％) ;In 25 hips with large amount of joint effusion,collapse occurred in 16 (64％) ;in 18 hips with bone marrow edema,collapse occurred in 13 (65％).Joint fluid,heterogeneous signal intensity and lesions in the superolateral quadrant,volume ratio,and area ratio were the high risk factors,while bone marrow edema was a relatively low risk factor.The area under ROC curves for area ratio of NASA was greater than that for volume ratio (0.987 vs 0.902).When the critical value for area ratio was 26.7％,the true positive rate was 95.2％,true negative rate was 94.4％,and Youden's index was 0.896.Conclusions The collapse of necrosis of femoral head may result from many factors.The femoral head was easy to collapse when it had large enough area of necrosis and mixed signal intensity,a large amount of joint effusion,bone marrow edema,and superolateral quadrant location.The critical value for area ratio to predict the collapse of femoral head was about 26.7％.The area ratio is more accurate than volume ratio in predicting the collapse of necrosis of femoral head.