BACKGROUND: The quantitative measurements based on magnetic resonance imaging (MRI) have been vastly used in evaluating the therapeutic efficacy on multiple sclerosis (MS).OBJ ECTIVE: To determine whether the effect of IFNB-1b on brain atrophy of MS could be shown with analysis of MRI measurement.DESIGN: Randomized controlled observation.SETTING : Center for Neurological Diseases, Utano National Hospital.PARTICIPANTS: Totally 188 patients with MS, including 55 males and 133 females aged from 16-59 years, averagely(36±11) years, from Center for Neurological Diseases, UtanoNational Hospital from January to December 1998 were enrolled. Inclusive criteria: ①according to Poser RR type criteria were considered as having MS for enrollment, ②Expanded Disability Status Scale (EDSS) score of 7.0 or less, ③at least 1 relapse in the past year or at least 2 relapses in the past two years prior to enrollment, but no relapse for 30 days before enrollment, stable neurological state for at least 1 month and negative results of the IFNB-1b needle-prick test, and ④they all knew the detected items and agreed. In the included patients, there were 148 cases of optic nerves and spinal cord type and 40 cases of classical type.METHODS: ①Drug treatment: All the patients were treated with IFNB-1b injectable preparation (provided by Japanese Pharmaceuticals Company). According to the different injected dosage, the patients were divided into low-dosage group (n =93) and high-dosage group (n =95), given with 1.6 million U and 8 million U of IFNB-1b subcutaneously on alternate days for 2 years. ②MRI examination: The patients received MRI in lesion site (optic nerves, cerebrum, cerebellum, brainstem, and spinal cord). T1 and T2-weighted axial MRI scan were performed by a single neurologist. The area of the MS lesions in T2-weighted images was summed slice by slice for a total lesion area and was recorded as mm2. Third ventricle, lateral ventricle width and brain width were measured and expressed by atrophy rate. ③Neurologic impairment examination: Neurologic impairment was evaluated with Kurtzke EDSS (from 0 point to 10 points, 0 point as normal, the higher score represented severe condition). ④Analysis of related factors: Correlation analysis was performed in brain atrophy condition and T2 focus area with EDSS score in 148 MS patients with typical MS. At the same time,correlation analysis was conducted between variance (age, progress, relapse rate, T2 focus area and EDSS score) and brain atrophy.MAIN OUTCOME MEASURES: ①Comparison of brain atrophy in patients of the two groups, and ②analysis of related factors of brain atrophy measurements.RESULTS: Totally 188 patients were involved in the result analysis. ①Outcome of brain atrophy comparison in the two groups: In classical type MS the rates of atrophy measures in high-dosage group were 2.84%, 3.15%, and 1.3% in lateral ventricle width, third ventricle width and brain width, respectively, and significantly lower than those in low-dosage group (4.09%, 5.36% and 1.97%, P ＜ 0.01). In optic nerve and spinal cord type MS patients, the rates of brain atrophy were 0.9%, 1.55% and 0.6% in lateral ventricle width, third ventricle width and brain width, respectively in high-dosage group, and there was no significant difference as compared with the low-dosage group (1.65%, 1.75% and 0.7%, P ＜0.05). ②There was significant correlation of lateral ventricle width, T2 focus area and EDSS score in classical MS patients (r =0.33,0.27, P ＜ 0.01 ). There was significant correlation of third ventricle width, T2 focus area and EDSS score (r=0.31,0.29, P ＜ 0.05). There was significant correlation of brain width, T2 focus area and EDSS score (r =0.11,0.14, P ＜0.05). There was significant correlation of baseline EDSS score and T2 focus area with lateral ventricle width (r =0.23,0.33, P ＜ 0.05). The other baseline variables failed to show a significant contribution to the process.CONCLUSION: The effects of IFNB-1b on brain atrophy were positive and significant differences were also found between both high- and low-dosage groups. This brain atrophy measurement provides an independent MRI confirmation of a therapy and dose effect of IFNB-1b for MS.

Background and Purpose:Lung cancer is the most malignant tumour in the world.Its incidence is growing and NSCLC is predominent(80%) in lung cancer.Most patients with lung cancer were diagnosed in late stages.The tumour could be shrunk by neoadjuvant chemotherapy when the case with stage Ⅲ NSCLC was considered not possible for radical operated neoadjuvant chemotherapy may lead to the following,operation could be improved,micrometastasis could be annihilated and survival could be extended.Objective of this paper was to analyse the prognostic factors for survival in patients treated by surgery and chemotherapy for NSCLC.Methods:98 cases of neoadjuvant chemotherapy combined with surgery for NSCLC,stageⅠ~Ⅲ,were collected retrospectively in our hospital from 1995 to 1997.35 cases were stageⅠ.21 cases were stage Ⅱ.42 cases were stage Ⅲ.83 cases had 1 cycle of chemotherapy pre-operatively.15 cases had 2 cycles chemotherapy pre-operatively.Regimes of chemotherapy were MVP,MOP and MAP et al.Response rate(RR) of chemotherapy was:45 cases had partial response(PR) and 53 cases were stable disease(SD).Operative mode was lobectomy and pneumectomy with lymph nodes dissection.Pathologic type was squamous,adeno,adeno-squamous and others.All the patients were treated by chemotherapy for two or three cycles after surgery except for the patients in stageⅠin 1996~1997.After being followed-up for more than 5 years,data were examined using life table,KaplanMeier method,Log Rank statistic and Cox-mantel test.The possible factors affecting survival were tested with univariate and multivariate analysis.Results:The median followed-up time of 98 cases for NSCLC was 41.2 months.36 cases were alive.62 cases were dead.The 1-,3-,5-year survival rate of 98 cases for NSCLC was 88.78%、49.63% and 18.46%.The 5-year survival rates of stageⅠ、ⅡandⅢ were 33.23%、20.26% and 5.52% respectively(P=0.0002).The 5-year survival rates of N_(0)、N_(1)、N_(2) were 35.49%、19.08% and 4.90% respectively(P=0.0004).In the 98 cases of NSCLC,better prognosis was correlated with earlier stage.The prognosis was better if the period from last chemotherapy before operation to operation was no more than 1 month. The prognosis of lobectomy,lung hila activity,thorax lymph nodes negativity and squamous cancer was better.The prognosis was poorer if the tumor had invaded big vessels,viscera,chest wall,pericardium and quantity bleeding during≥400ml.The prognosis was better if the tumor was fibrotic.The prognosis of 2 cycles of chemotherapy pre-operatively might be better than 1 cycle.The prognosis of tumor necrosis was poorer and the prognosis of chemotherapy post-operatively was better.Conclusions:The main prognostic factors affecting survival in patients treated by surgery and chemotherapy for NSCLC was stage,the period from last chemotherapy before operation to operation,operation mode,lung hila activity,thorax lymph nodes,site of tumor invasion,bleeding quantity,pathologic type,tumor fibrosis and necrotis,cycles chemotherapy pro-operation and chemotherapy post-operation.

BACKGROUND AND OBJECTIVEThe aim of this study is to evaluate diagnostic yield and the safety of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis ofbronchogenic carcinoma.

METHODSBetween July, 2009 and February, 2010, 95 patients with mediastinal/hilar lymphadenopathy and/or intrathoracic peritracheal or peribronchial masses previously detected with CT scan underwent EBUS-TBNA. No rapid onsite cytology was performed.

RESULTSIn all 95 patients, 60 cases were newly diagnosed lung cancer through the pathological examination and clinical follow-up certification. In 60 lung cancer cases, 112 samples were obtained from lymph nodes (LNs) and 11 samples were obtained from intrapulmonary lesions. Fifty-eight cases of patients were diagnosed, false negative in 2 cases. Sensitivity and specificity of EBUS-guided TBNA method in distinguishing benign from malignant LNs or thoracic masses were 96.67% and 100%, respectively. There was any major complication in this series, the procedure was uneventful.

CONCLUSIONEBUSTBNA seemed a safe and effective technique in making bronchogenic carcinoma diagnosis for mediastinal/hilar LNs and intra-pulmonary masses.

Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; methods ; Bronchi ; diagnostic imaging ; pathology ; Carcinoma, Bronchogenic ; diagnosis ; Endosonography ; methods ; Female ; Humans ; Lung Neoplasms ; diagnosis ; Male ; Middle Aged

Objective To explore the differences in tremor characteristics between patients with primary Parkinson's disease(IPD),essential tremor(ET),and Parkinson's disease developed from essential tremor(ET-PD).Method Thirty IPD patients,30 ETs,and 20 ET-PD patients were included,and the frequency,contraction pattern,and presence of harmonics of static and postural tremors were compared among the three groups.Results There were statistically significant differences(P<0.01)among the IPD group,ET group,and ET-PD group in terms of age of onset,disease course,and the unified Parkinson's disease rating scale(UPDRS)score.There were statistically significant differences(P<0.05)in the average frequency of stationary tremors,average frequency of postural tremors,rate of alternating tremors in stationary state,rate of alternating tremors in postural state,and rate of harmonic occurrence in stationary state among the IPD group,ET group,and ET-PD group,as well as in the rate of harmonic occurrence in postural state(P<0.05).Conclusion The IPD group,ET group,and ET-PD group each have significant differences in tremor characteristics.The ET-PD group has both characteristics and uniqueness,and tremor analysis can help identify this disease.