1.Magnetic resonance imaging diagnosis of central neurocytoma
Weijun ZHOU ; Mingzhen JI ; Yafang DOU ; Bin SHEN
Chinese Journal of Postgraduates of Medicine 2014;37(30):21-23
Objective To evaluate the characteristic appearance and diagnosis value of central neurocytoma on magnetic resonance imaging (MRI).Methods MRI data of 9 patients with central neurocytoma confirmed surgically and pathologically were retrospectively reviewed.Results All the lesions located in the lateral ventricle septum pellucidum,adjacent to Monro hole,in the anterior 1/3 to 2/3 of the lateral ventricle.Most of them were irregularity,sublobe and sharpness of border.They presented as inhomogeneous intense signal on MRI,with slight to equal enhancement on enhancement.DWI could be high or slightly high signal.Conclusion Central neurocytoma has the characteristic appearances on MRI,being helpful to the diagnosis.
2.Clinical research of oral contraceptive and levonorgestrel-releasing intrauterine system after hysteroscopic endometrial polypectomy in preventing recurrence
Chinese Journal of Postgraduates of Medicine 2014;37(30):24-27
Objective To explore the recurrence-prevention effect of oral contraceptive and levonorgestrel-releasing intrauterine system (Mirena) after hysteroscopic endometrial polypectomy.Methods One hundred and seventy-four patients who received hysteroscopic endometrial polypectomy were enrolled in this research.The patients were informed and divided into three groups according to their selection:51 cases were given oral contraceptive since one month until 12 months after the surgery (oral contraceptive group); 60 cases were received Mirena since one month after the surgery (Mirena group) ; and 64 cases were received no treatment after the surgery (control group).The groups were followed up at 3,6,12 months after the surgery and compared the recurrence rate,menstruation,level of hemoglobin and complication rate.Results The recurrence rate in oral contraceptive group,Mirena group and control group was 3.9%(2/51),3.3% (2/60) and 19.0% (12/63),respectively.The recurrence rate in control group was higher than that in oral contraceptive group and Mirena group,and there was significant difference (P < 0.05).The proportion of low menstruation volume in control group was lower than that in oral contraceptive group and Mirena group,and there was significant difference (P < 0.05).The level of hemoglobin in control group was lower than that in oral contraceptive group and Mirena group [(124.55 ±9.33) g/L vs.(133.71 ± 11.03),(135.89 ±6.88) g/L],and there was significant difference (P < 0.05).The incidence of complication in Mirena group [18.3% (11/60)] was less than that in oral contraceptive group[35.3%(18/51)],and there was significant difference (P < 0.05).Conclusions Oral contraceptive and Mirena after hysteroscopy for endometrial polys significantly decrease the recurrence rate.The complication rate of Mirena is lower and it is a safe and effective way to treat and prevent the endometrial polyp.
3.Value of two-dimensional ultrasound diagnosis of medullary thyroid carcinoma
Wei WEI ; Fang YUAN ; Jinpeng HE
Chinese Journal of Postgraduates of Medicine 2014;37(30):58-59
Objective To analyze the value of two-dimensional ultrasound diagnosis of medullary thyroid carcinoma.Methods The two-dimensional ultrasonographic manifestations of 18 nodules in 13 medullary thyroid carcinoma patients pathologically confirmed were analyzed retrospectively.Results In 18 nodules of medullary thyroid carcinoma,18 nodules were hypoechoic,13 nodules were irregular shaped,14 nodules had unclear boundaries,15 nodules with an aspect ratio less than 1,13 nodules had calcifications and 9 patients had neck lymphatic enlargement.Conclusion Medullary thyroid carcinoma has some two-dimensional ultrasonographic manifestations:hypoechoic nodules,no obvious envelope with coarse calcification and widely distributed,and tiny calcified nodules of hypoechoic,round,non-calcified with an aspect ratio greater than 1 and the diameter less than 10 mm should be wary of medullary thyroid carcinoma.
4.The value of cerebrospinal fluid lactic acid and beta-2-microglobulin in the diagnosis of bacterial meningitis
Na ZHAO ; Dongmei LI ; Hengpeng HE ; Xia ZHOU
Chinese Journal of Postgraduates of Medicine 2014;37(31):48-50
Objective To explore the significance of cerebrospinal fluid lactic acid (LA) and beta2-microglobulin (β2-MG) on the diagnosis of bacterial meningitis,and study their values compared with white blood cell (WBC) or protein in cerebrospinal fluid.Methods Thirty patients with bacterial meningitis were selected as bacterial meningitis group,and 30 surgical patients requiring spinal anesthesia were as control group.The level of cerebrospinal fluid LA was detected by Vitros950 automatic analyzer,and the level of cerebrospinal fluid β2-MG was detected by automatic AIA1800 enzyme immune analyzer.SPSS 13.0 and receiver operating characteristic curve (ROC curve) was used to analyze the data.Results The cerebrospinal fluid LA level in bacterial meningitis group was 1.53 (0.50) mmol/L,in control group was 1.11 (0.34) mmol/L,and there was statistical difference (P < 0.05).The cerebrospinal fluid β 2-MG level in bacterial meningitis group was 2.61 (1.00) mg/L,in control group was 0.83 (0.45) mg/L,and there was statistical difference (P < 0.01).For bacterial meningitis diagnosis,the areas under the ROC curve of cerebrospinal fluid WBC,protein,LA and β2-MG were 0.760,0.936,0.705 and 0.960.The best boundary value of LA in bacterial meningitis diagnosis was 1.78 mmol/L with a sensitivity of 68.0% and specificity of 88.9%.The best boundary value of β2-MG in bacterial meningitis diagnosis was 1.756 mg/L,with a sensitivity of 92.0% and specificity of 99.4%.Conclusions Both cerebrospinal fluid LA and β 2-MG is valuable in the diagnosis of bacterial meningitis.But for the diagnostic value,cerebrospinal fluid LA is not as good as WBC or protein in cerebrospinal fluid,but β2-MG is better than them.It has high sensitivity and specificity.
5.The relationship of carotid artery stenosis and early postoperative cerebrovascular accident in patients undergoing coronary artery bypass grafting
Huajing XU ; Hairui ZHANG ; Junqing FENG ; Hongxing NIU
Chinese Journal of Postgraduates of Medicine 2014;37(32):18-20
Objective To investigate the relationship of carotid artery stenosis and early postoperative cerebrovascular accident in patients undergoing off-pump coronary artery bypass grafting.Methods One hundred patients with carotid artery stenosis were divided into two groups by random digits table method:off and on-pump coronary artery bypass grafting group.The incidence of early cerebral vascular accident after operation in two groups (48 h after operation) was compared and analyzed.Results The rate of early postoperative cerebral vascular accident in on-pump coronary artery bypass grafting group was 18.2% (8/44),1 patient occurred cerebral infarction,7 patients occurred transient ischemic attack,none occurred cerebral hemorrhage.The rate of early postoperative cerebral vascular accident in off-pump coronary artery bypass grafting group was 5.4%(3/56).The rate of early postoperative cerebral vascular accident between two groups had significant difference (x2 =4.141,P =0.042).Conclusion The patients with carotid artery stenosis with off-pump coronary artery bypass grafting can reduce early postoperative cerebral vascular accident.
6.Expression of MTSS1 and E-cadherin in upper urinary tract transitional epithelial carcinoma
Huaian CHEN ; Xueqin BAI ; Zhe WANG ; Wenlong MIAO ; Xiaoyun ZHANG ; Hongwei SU ; Shuo LIU
Chinese Journal of Postgraduates of Medicine 2014;37(32):20-22
Objective To investigate the significance of MTSS1 and E-cadherin expression in upper urinary tract transitional epithelial carcinoma.Methods Paraffin specimens of 60 patients with upper urinary tract transitional epithelial carcinoma between January 2005 and January 2014 were analyzed.At the same time,5 cm normal tissue adjacent to the cancerous tissue specimens in 30 patients were taken for comparison.Immunohistochemical method was used to detect the tissue MTSS1 and E-cadherin expression,and the relationships between their expression with different pathological stage,differentiated degree and lymph node metastasis were analyzed.Results MTSS1 expression rate in normal tissue (100.0%,30/30) was significantly higher than that in cancerous tissue (45.0%,27/60) and there was significant difference (P < 0.05).E-cadherin expression rate in normal tissue (96.7%,29/30) was significantly higher than that in cancerous tissue (41.7%,25/60) and there was significant difference (P < 0.05).The expression of MTSS1 and E-cadherin in different pathological stage,degree and with or without lymph node metastasis had significant difference (P < 0.05).In patients with well differentiated,low TNM stage and no lymph metastasis,MTSS1 and E-cadherin expression rate was higher (P < 0.05).There was no significant correlation between the expression of MTSS 1 and E-cadherin in cancerous tissue (P > 0.05).Conclusion In upper urinary tract transitional cell carcinoma detection of both MTSS1 and E-cadherin has important significance with regards to judging the malignant degree of the tumor,lymph node metastasis and prognosis in patients.
7.The assessment of gastric emptying function of diabetic gastroparesis by gastroenteric contrastenhanced ultrasonography
Jun WU ; Zhijun ZHAO ; Gaiping ZHAO ; Yucang HU ; Xiaodong HOU
Chinese Journal of Postgraduates of Medicine 2014;37(33):10-12
Objective To detect the changes of gastric emptying function by gastroenteric contrastenhanced ultrasonography and to offer the evidence for the diagnosis and treatment of diabetic gastroparesis.Methods The gastric emptying function was measured by gastroenteric contrast-enhanced ultrasonography in 35 cases of diabetic gastroparesis (DGP,DGP group) and 35 volunteers (control group).The gastric emptying rate(GER) and emptying time(ET) after taking orally gastroenteric ultrasound developer in DGP group were observed and compared with control group.Results The GER in DGP group was lower than that in control group [(27.05 ± 11.32)% vs.(45.38 ± 15.08) %] (P < 0.05).The ET in DGP group was longer than that in control group[(102.43 ± 15.76) min vs.(75.31 ± 11.52) min] (P < 0.05).Conclusions The method of gastroenteric contrast-enhanced ultrasonography is a simple,and repeatable imaging method,which can be used to make a real-time assessment on the gastric dynamic changes,but don't influence gastroenteric function and can provide a dependent and noninvasive examine means for clinical physician to test the gastric emptying function in DGP.
8.Relationship between bronchoalveolar lavage fluid Mycoplasma load and clinical characteristics in children with Mycoplasma pneumoniae pneumonia
Weimin CHEN ; Xihui ZHOU ; Xingyu LUO ; Huiru YI
Chinese Journal of Postgraduates of Medicine 2014;37(33):12-15
Objective To explore the relationship between bronchoalveolar lavage fluid (BALF) Mycoplasma load and clinical characteristics in children with Mycoplasma pneumoniae (MP) pneumonia.Methods MP DNA was quantitatively detected by fluorescent real-time PCR in BALF from 67 children with MP pneumonia.They were classified into three groups:low MP load group (< 103/ml,21 cases),moderate MP load group (103-106/ml,22 cases) and high MP load group (> 106/ml,24 cases).Clinical symptom,main laboratory and imaging results of children among three groups were compared.Results When compared with low MP load group and moderate MP load group,high MP load group had longer fever duration [(7.4 ± 2.6),(10.0 ± 2.4) d vs.(12.4 ± 2.7) d],longer time to normalization of temperature with macrolide administration [(4.2 ± 1.0),(8.5 ± 2.4) d vs.(10.8 ± 4.4) d],more patients with high fever,there was significant difference (P < 0.05).Statistically significant difference existed in C-reactive protein among three groups [(3.0 ± 1.4),(11.5 ±7.6),(34.0 ± 10.1) mg/L] (P =0.004).Large field of consolidation or atelectasis were found in 58.3% (14/24) of high MP load group,much higher than 22.7% (5/22) in moderate MP load group and 14.3% (3/21) in low MP load group.Bilateral or massive pleural effusion was not found in low MP load group,while in moderate MP load and high MP load group,they were 13.6 % (3/22) and 25.0% (6/24)(P =0.033).Conclusions There is a close relationship between MP load in BALF and clinical characteristics in children with MP pneumonia.Those with high MP load have a more severe process.
9.Detection of peak expiratory flow in 446 healthy children in Chengdu
Lei ZHANG ; Tao AI ; Ronghua LUO ; Yan REN
Chinese Journal of Postgraduates of Medicine 2014;37(33):16-18
Objective To explore the reference values of peak expiratory flow (PEF) for 4.0-14.0 years old children in Chengdu.Methods From November 2011 to May 2012,a total of 446 healthy children were enrolled in this study.PEF was measured using expiratory peak velocimeter and lung function meter.Children's age,sex,height and weight were recorded.Impact factors for PEF were investigated by multiple stepwise regression analysis.Results The PEF detected by expiratory peak velocimeter and lung function meter had a good correlation (r =0.920,P < 0.01).Boys own higher peak expiratory flow rate than girls.The level of PEF had the best correlation with height,next was weight and age.The level of PEF increased with the increase of height,age.Some children PEF value was less than 80% lower limits of lower limits of normal.The PEF could be obtained from height and age.Conclusions Males and females PEF can be calculated according to children's height.Set up the PEF equation about the expiratory peak velocimeter and lung function meter.
10.The clinical utility of improved percutaneous lung biopsy under CT guidance
Fuxing CHEN ; Mingjin SU ; Hui LI ; Tiefeng LI ; Yanbiao HU ; Pingkun XIE ; Yu ZOU
Chinese Journal of Postgraduates of Medicine 2014;37(33):44-46
Objective To discuss the clinical value of improved percutaneous lung biopsy under CT guidance.Methods Reviewed the clinical data of 80 cases of improved percutaneous lung biopsy under CT guidance,which were confirmed by surgery or pathology.When took the operation,18 G semi-automatic cutting biopsy needle (made in American Cook's company) was used to improve the ways of positioning scan,two-step method of insert the needle,and the cutting technique of coaxial in each direction.Results All of the 80 patients were successfully completed pathological biopsy,successful rate was 100.0% (80/80),and diagnosis rate was 98.8% (79/80),incidence of complication was 10.0 % (8/80),all of these patients were recovered after treatment 2-5 d.Conclusion The method of improved percutaneous lung biopsy under CT guidance is safe,effective,simple and practical,which has high successful rate and low complication rate,the generalizability is certain.