Objective To validate the theraputic efficacy of percutaneous ethanol injection(PEI) for hyperparathyroidism caused by parathyroid adenoma.Methods One case of parathyroid adenoma underwent PEI whose diagnosis was comfirmed by biopsy. The 22 gauge needle was punctured into the adenoma under CT guidance and ethanol was injected into the lesion at multiple points. Results The CT images obtained 6 months after 2 times of CT guided PEI revealed that the volume of the adenoma decreased markedly together obviously with decrease of enhancement after the injection of contrast media. The level of serum parathyroid hormone, calcium and phosphorous returned normal 2 days to 12 months after the management. The clinical manifestations improved markedly.Conclusions CT guided PEI is a minimally invasive and highly effective theraputic modality for hyperparathyroidism. It can serve as an important supplement to surgery.

0.05). The MIP image should be used to select the optimal projection angle and measure the aneurysm, while the SSD image was for reference only. Conclusion SCTA can not only diagnose cerebral aneurysms accurately but also has high directive value in making therapy plan, surgical preparation and endovascular embolization.

Objective To evaluate the effects of percutaneous computed tomography-guided ethanol injection (PEI-CT) in adrenal benign functioning tumors. Methods Twenty cases of adrenal benign functioning tumors were treated by the therapy of PEI-CT. Among them, 5 cases were pheochromocytomas, and 15 cases were aldosteronomas. After the treatment, the change of blood pressure, aldosterone plasma levels, potassium plasma levels, and catecholamines urine levels was investigated. Both plain and enhanced CT scans were performed before and after the treatment to evaluate the changes of the size and necrosis in the tumors. Results Normalization of blood pressure and catecholamines urine levels was observed in 5 cases of pheochromocytoma during 6-19 months′ follow up after the treatment. In the 15 cases of aldosteronoma, aldosterone plasma levels reduced with potassium plasma levels increasing to the normal range within 5-7 days after the treatment. Aldosterone plasma levels increased with potassium plasma levels reduced again in 7 months after the treatment in one case, aldosterone plasma levels and potassium plasma levels returned to the normal range after the second treatment. Hypertension returned to normal in 13 cases of aldosteronoma, and one case maintained normal blood pressure (BP) only under the condition of taking lower dosage of spironolactone within 7-15 days after the treatment, and one month later, the blood pressure of the case become normal without taking any antihypertensive drugs. The other case maintained normal blood pressure in the need of taking lower dosage of antihypertensives after the treatment. CT scan showed total necrosis of tumors in 15 cases and majority necrosis in 5 case within 7-15 days after the treatment. Conclusion The therapy of percutaneous computed tomography-guided ethanol injection in adrenal benign functioning tumors shows satisfactory effects with the advantages of easy manipulation, safety, less injury and cost.

Objective To investigate the CT and MRI features of the autoimmune pancreatitis (ALP).Methods CT and MRI data of fourteen patients with AIP who were confirmed by histology and/or steroid therapy were retrospectively analyzed.Ten patients underwent CT examination, and seven patients underwent MRI, while three patients underwent both CT and MRI examinations.Results It was showed that diffuse (n =11 ) or local ( n = 3 ) enlargement of pancreas.CT features showed that the hypoattenuation pancreatic lesions on unenhanced CT (n = 10);segmental pancreatic duct could be seen in five patients;stenosis of common bile duct in the head of pancreas was observed in 5 patients;the capsule-like structure around lesions was seen in seven patients.Delayed homogeneous enhancement was showed on enhanced CT.MRI features included homogeneous ( n = 3) and heterogeneous ( n = 4) hyperintense on T1 WI with fat-suppression images and homogeneous ( n = 3 )and heterogeneous (n =4) hyperintense on T2WI with fat-suppression images.Pancreatic duct could be seen in four patients.MRCP showed pancreatic duct stenosis in the head of pancreas ( n = 1 ) and segmental pancreatic duct (n = 2).Stenosis of common bile duct in the head of pancreas was showed in 5 cases.The capsule-like structure around lesions was showed in seven patients.No pancreatic calcification was revealed, and no significant pancreatic duct dilation was detected ( ＞3 mm) in all 14 patients.Conclusions The CT and MRI manifestations of AIP had characteristic features such as sausage-like changes of the pancreas, capsule-like structure around the lesions, diffuse or local pancreatic duct stricture, and stenosis of common bile duct in the bead of pancreas.

Alzheimer’s disease (AD) is a chronic degenerative disease of central nervous system.The disease onset slow,early typical performance for the decline in judgment,lack of initiative,moodiness,etc,clinical manifestations of memory loss, cognitive dysfunction based.Cerebrolysin is a akind ofneurotrophicpeptidegic mixture obtained by normalized enzymolysisof lipid-free porcine brain proteins,it is rich in various amino acids,small molecule polypeptide and various essential elements such as magnesium, phosphorus and selenium.Several studies have shown that cerebrolysin can significantly improve the memory,anxiety,fatigue,dizziness and other symptoms of AD patients.In this paper,the research progress of cerebrolysin in treatment of Alzheimer’s disease were reviewed to provide reference for the comprehensive development and clinical application of cerebrolysin .

Normotensive primary hyperaldosteronism is rare. One case of this syndrome treated with alcohol injection was reported, and the clinical manifestation and laboratory data were analysed and discussed.

Objective: To study the diagnosis and treatment of primary hyperparathyroidism.Methods: The clinical data of 8 primary hyperparathyroidism patients(1992 2002) in our hospital were summarized and the references were reviewed.Results: It was found that primary hyperparathyroidism was liable to be misdiagnosed.Information on blood calcium,parathyroid hormone(PTH) and imaging may be helpful for diagnosis. Surgical resection(4 cases), anhydrous alcohol injection (2 cases), electron radiation (1 case) and internal medicine (1 case) were applied. Conclusion:Information on blood calcium,PTH and early imaging is helpful for diagnosis.Operation is the first choice of treatment, and for patients who can not tolerate surgery, anhydrous alcohol injection is an effective and safe treatment.

Objective To investigate the value ofin vivo proton MR spectroscopy(1H-MRS)in the assessment of large focal hepatic tumors.Methods Fifty-three consecutive patients with 54 large(no less than 4 cm in dimneter)hepatic tumors and 19 normal volunteers were:included in this study.MRS of the 25 HCC confirmed by pathological examination,the choline-to-lipid mtios(Cho/Lip)were measured by dividing the peak area of choline at 3.2 ppm and lipid at 1.3 ppm.Differences in the ratios of normal liver,benign tumors and HCC were analyzed by Dunnett-t test.The sensitivity and specificity prof'des of 1H-MRS in the diagnosis of HCC were determined by plotting receiver operating characteristic(ROC)curves.Results The mean Cho/Lip ratios for normal liver(n=17),benign tumor(n=8),and HCC(n=25)were 0.07±0.04,0.11 ±0.06 and 0.55±0.17,respectively(F=6.58,P＜0.05).A significant statistical difference was found in the mean Cho/Lip ratios between HCC and benign liver tumors or normal liver(t=2.99,2.32;P＜0.05).But there wag no difference between benign hepatic tumors and norlnal liver(t=1.53,P＞0.05).The ROC curve showed proton MRS had moderate discriminating ability in diagnosing HCC.The area under the curve was 0.77. If 0.1 was chosen ns the cut-off value for diagnosing HCC with MRS,the sensitivity and specificity for HCC were 80.0%and 62.59b,respectively.Conclusion In vivo proton MRS is technically feasible for the evaluation of focal hepatic lesions,and may be useful in the diagnosis and differential diagnosis of HCC by providing metabolic ifformafion.

Objective To establish a big animal model of secondary infection of acute necrotizing pancreatitis (ANP). Methods Thirty young pigs were allocated to experiment group ( n = 20 ) or control group (n = 10). The ANP model was induced by retrograde injection of a mixture solution of 5% sodium taurocholate and 5% trypsin (0. 5 ml/kg body weight) into the main pancreatic duct and ligation of the proximal end of the main pancreatic duct, and then the second step was injecting 3 ～ 4 ml living Escherichia coli (E coli) suspension (108/ml) to the necrotic area of the pancreas by fine needle aspiration technique under CT guidance in the experiment group, and by injecting 3 ～ 4 ml inactivated E coli in the control group using the same method. Multi-slice spiral CT dynamic enhanced scan was performed in both groups 1 day and 2 or 3 days after ANP modeling and 5 days after bacterial injection to calculate the CTSI score. Serum amylase, blood WBC count and blood bacterial culture was performed in both groups. 5 days later, the animals were scarified to observe the infected or necrosis foci, and perform smear, bacterial culture and pathologic examinations of the tissue around the infected or necrosis foci. Results The ANP secondary infection model was successfully established in 16 of the 20 animals in the study group, with a success rate of the 80.0% (16/20). There were 17 foci where the positive rate of bacterial culture was 100% (17/17 foci), and the success rate of blood bacterial culture was 68.8%(11/16). In the control group, the ANP model was established successfully in 7 of 10 animals (70%), except for one case of contamination, only one foci was identified;the positive rate of bacterial culture and the success rate of b|ood bacterial culture was 14.3% (1/7). Serum amylase and white blood WBC count increased with similar trends, WBC count in the study group was significantly higher than that in the control group (P<0.01). The mean CT severity index(CTSI) was all ≥4 in beth groups, indicating the severity was moderate to severe. Conclusions A stable and reliable model of secondary infection of ANP in big could be established satisfactorily by injecting active E. coli into the pancreatic necrosis tissue under CT guidance, which helps further pathogenic mechanism studies and clinical studies, especially imaging studies.

Objective To determine the serum concentration of MCP-1 and the expression of MCP-1 protein in the pancreas in the piglet with chronic obstructive pancreatitis and to explore the role of MCP-1 protein in pancreatic fibrosisits.Methods The piglet model of chronic obstructive pancreatitis was established by incomplete ligation of the pancreatic duct.The piglets were sacrificed at 4, 6, 8 weeks after induction.Pathological changes of pancreas were examined.Pancreatic fibrosis was assessed by VG staining.Serum MCP-1 concentrations were detected by ELISA method.MCP-1 and α-SMA, PDGF, TGF-β1 and NF-κB protein expression were detected by immunohistochemistry.Results The induction was successful in 14 piglets ( 58.3% ).Mild atrophic changes, interstitial fibrosis, chronic inflammatory cell infiltration could be observed in the body and tail of pancreas from the 4th week in the experimental group.The most obvious changes occurred in the 8th week.Stage Ⅰ pancreatic fibrosis occurred in 5 piglets (35.7%), stage Ⅱ in 4 piglets (28.6%), stage Ⅲ in 5 rats ( 35.7% ).Seurm MCP-1 at 4, 6, 8 weeks was ( 102.44 ± 36.25 ) pg/ml,(97.84 ± 28.67) pg/ml, ( 94.32 ± 28.42 ) pg/ml, respectively, and was significantly higher than that in control group [ ( 10.42 ±5.86) pg/ml, (8.58 ±4.86) pg/ml, (8.22 ±4.58) pg/ml, P ＜0.01 ].There was no MCP-1 protein expression in the control group;MCP-1 protein was detected in the successful induction group, and MCP-1 expression was positively correlated with expressions of the PDGF, TGF-β1, α-SMA and NF-κB.Conclusions MCP-1 may play an important role in the course of pancreatic fibrosis in chronic obstructive pancreatitis.