Objective To investigate the features of computed tomography (CT) and magnetic resonance imaging (MRI) on pancreatic neuroendocrine tumors (pNENs).Methods The retrospective and descriptive study was adopted.The clinicopathological data of 33 patients with pNENs who were admitted to the Tongji Hospital of Tongji Medical School of Huazhong University of Science and Technology between May 2012 and February 2016 were collected.All the patients underwent plain and enhanced scans of CT and MRI.Observation indicators:(1) overall imaging findings and pathological results of pNENs,(2) imaging findings of functional pNENs,(3) imaging findings of non-functional pNENs.Main analysis indicators included tumor diameter,location,boundary,density,cystic degeneration,enhancement,signal,calcification,with or without pancreaticobiliary duct dilation,with or without surrounding tissues invasion,lymph node and distant organ metastases.Results (1) Overall imaging findings and pathological results of pNENs:of 33 patinets with pNENs,24 underwent CT examination,3 underwent MRI examination and 6 underwent CT and MRI examinations.Tumors of 33 patients were solitary with a diameter of 0.6-16.0 cm.Ten,1,13 and 9 tumors were respectively located at the head of pancreas,uncinate process of pancreas,body of pancreas and tail of pancreas.Thirty-three patients were diagnosed as pNENs by pathological examination,including 20 with functional pNENs (insulinoma) and 13 with non-functional pNENs,and G1,G2 and G3 were respectively detected in 24,7 and 2 patients.The coincidence rate between preoperative CT or MRI examination and pathological examination was 90.9％ (30/33).One,1 and 1 patients were misdiagnosed as pancreatic cancer,enlargement of peripancreatic lymph nodes and duodenal gastrointestinal stromal tumor,respectively.(2) Imaging findings of functional pNENs:tumor diameter of 20 patients with functional pNENs was 0.6-3.0 cm with an average diameter of 1.5 cm.Fòur,10 and 6 tumors were respectively located at the head of pancreas,body of pancreas and tail of pancreas.Of 20 patients with functional pNENs,tumors of 19 patients showed clear boundary and 1 showed unclear boundary,and tumors of 18 patients had uniform density and 2 had uneven density with cystic degeneration,without the occurrence of calcification.Of 20 patients undergoing dynamic enhanced scans,tumors of 19 patients demonstrated obvious enhancement in arterial phase and slightly obvious enhancement or were equal to normal pancreatic tissues in portal vein phase and lag phase,and tumor of 1 patient demonstrated slight enhancement in arterial phase and was equal to or less than normal pancreatic tissues in portal vein phase and lag phase.Tumors in 3 patients undergoing MRI scans were manifested as hypointensity on T1-weighted imaging (T1WI),hyperintensity on T2WI and hyperintensity on DWI (b =1 000 s/m2),with clear imaging.Of 20 patients,1 was accompanied with atrophy of pancreatic tissues at distal tumor,pancreatic duct dilatation,multiple retention cyst and enlargement of lymph nodes around the hepatic artery.(3) Imaging findings of non-functional pNENs:tumor diameter of 13 patients with non-functional pNENs was 1.5-16.0 cm with an average diameter of 5.0 cm.Six,1,3 and 3 tumors were respectively located at the head of pancreas,uncinate process of pancreas,body of pancreas and tail of pancreas.Of 13 patients with non-functional pNENs,tumors of 11 patients showed clear boundary and 2 showed unclear boundary,tumors of 3 patients had uniform density and 10 had uneven density with cystic degeneration,and tumors of 2 patients had calcification.Of 13 patients undergoing dynamic enhanced scans,tumors of 12 patients demonstrated obvious enhancement in arterial phase,continuous enhancement in portal vein phase and lag phase and less obvious enhancement at cystic degeneration area,with marked enlargement of supplying arteries and draining veins in partial tumors.Tumor of 1 patient demonstrated slight enhancement,and its enhancement was slightly less than normal pancreatic tissues in arterial phase,portal vein phase and lag phase,with unclear boundary.Results of MRI scans in 6 patients showed that tumors of 4 patients were manifested as hypointensity on T1WI,slight hyperintensity or mixed signal on T2WI and hyperintensity on DWI (b =1 000 s/m2),and tumors of 2 patients were manifested as hypointensity on T1WI,hypointensity on T2WI and hyperintensity on DWI (b =800 s/m2).Of 13 patients with non-functional pNENs,4 had pancreaticobiliary duct dilation and 7 had local tissues invasion or distant organ metastasis (4 with liver metastasis,1 with peripanereatic lymph node metastasis,1 with liver and peripancreatic lymph node metastases and 1 with liver metastasis combined with splenic venous and arterial invasion),including 1 in G1,4 in G2 and 2 in G3.Of 5 patients with tumor diameter ＞ 5.0 cm,4 were complicated with liver or lymph node metastases.Conclusions CT and MRI features of pNENs have a certain characteristics.For functional pNENs,benign and solid tumor is common,with clear boundary and smaller diameter.For non-functional pNENs,tumor size is bigger and cystic necrosis occurs within the tumor,with various enhancements.

Objective To investigate the intervening effect of transcutaneous electrical nerve stimulation plus auricular plaster therapy on depression and self-esteem in elderly patients with coronary heart disease. Methods One hundred and twenty-eighty patients with coronary heart disease were randomized to groups A, B, C and D, 32 cases each. Group A received conventional medication and health education. In addition to those given to group A, group B received auricular plaster therapy; group D, transcutaneous electrical nerve stimulation; group C, transcutaneous electrical nerve stimulation plus auricular plaster therapy. The Hamilton Depression Scale (HAMD) score and the Rosenberg self-esteem scale (RSES) score were recorded in every group before and after treatment. Results There were statistically significant pre-/post-treatment differences in the HAMD score and RSES score in all the four groups (P<0.05, P<0.01). After the intervention, the HAMD score and RSES score in group D were significantly different from those in group A (P<0.05). Conclusion Transcutaneous electrical nerve stimulation plus auricular plaster therapy and conventional medication helps to relieve depression and raise self-esteem in elderly patients with coronary heart disease.

Objective To create life story book with Chinese characteristics for senile dementia patients and to provide basis for subsequent life intervention. Methods Literature reviewing, patient interviewing (4 patients aged from 75 to 90 years old, with mild or moderate dementia were interviewed) and expert consulting were applied to establish the content, structure, form and usage of the life story book of Chinese senile dementia patients. Results Based on the common experience of Chinese old adults who were born during the age of 1920' s to 1950' s and the theme of life span, life story book for dementia patients. The Shining Days was created. Conclusions It is feasible to create life story books with Chinese characteristics for individuals with dementia by literature reviewing, patient interviewing and expert consulting.

Objective To explore the feasibility , necessity and teaching content of integrated traditional Chinese medicine and western medicine nursing education in Adult Nursing curriculum, and to provide the basis of building the content of textbook on the integrated traditional Chinese medicine and western medicine in Adult Nursing.Methods One hundred and sixty experts , who were chief editors , deputy editors and editors and attended the meeting to compile the nursing textbook for National Traditional Chinese Medicine University in August 14-16th, 2011 in Hangzhou, were surveyed by self-designed questionnaire .Results Thinking that Chinese nurses should receive the traditional Chinese medicine nursing education accounted for 80%;Thinking that carrying out the integrated traditional Chinese medicine and western medicine nursing in the clinical practice was necessary accounted for 93.1%;Thinking that clinical nursing course should combine with the knowledge of integrated traditional Chinese medicine and western medicine nursing accounted for 73.8%; Thinking that clinical nursing course should be integrated into the health preserving of traditional Chinese medicine and preventive health care knowledge accounted for 88.7%.Thinking that the disease kinds which fitted to combine with more than 50%of knowledge of integrated traditional Chinese medicine and western medicine nursing were 44 in the common diseases of medicine and surgery .Conclusions The content of textbook on Adult Nursing should combine with the knowledge of integrated traditional Chinese medicine and western medicine nursing , and that is feasibility and necessity .

OBJECTIVETo assess the effect of Qingfei Quyu Decoction (QQD) in preventing radiation pneumonitis in esophageal carcinoma patients by concurrent using it with chemoradiotherapy.

METHODSA total of 120 patients with mid-late stage esophageal carcinoma were randomly assigned to the treatment group (60 cases) and the control group (60 cases). All patients received concurrent radiochemotherapy. Patients in the treatment group additionally took QQD, one dose per day for 8 successive weeks. The incidence of radiation pneunonitis was compared between the two groups. The improvement rates of short-term benefit rate, Karnofsky performance scale (KPS), and body weight (BW) improvement rate were calculated between the two groups. The 1-and 2-year overall survival rates were compared between the two groups.

RESULTSThe incidence of radiation pneunonitis was 8.93% (15/56) in the treatment group and 18.64% (11/59) in the control group (P < 0.05). The short-term benefit rate was 92.86% (52/56) in the treatment group and 69.49% (41/59) in the control group (P < 0.05). Besides, the KPS and BW improvement rate were higher in the treatment group [89.29% (50/56) and 83.05% (49/59) ] than in the control group [80.36% (45/56) and 66.10% (39/59)] (P < 0.05). The 1-and 2-year overall survival rate were 66.07% and 35.71% in the treatment group, higher than those of the control group (61.02% and 30.51%; P > 0.05).

CONCLUSIONConcurrent using QQD with chemoradiotherapy for treating esophageal carcinoma patients could lower the incidence of radiation pneumonitis, attenuate the degree of radiation induced lung injury, improve clinical benefit rate, and elevate their QOL.

Carcinoma, Squamous Cell ; Chemoradiotherapy ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Esophageal Neoplasms ; drug therapy ; radiotherapy ; Humans ; Radiation Pneumonitis ; prevention & control ; Survival Rate

OBJECTIVESTo analyze the mood factors in prostatitis and evaluate the effects of Molida psychological therapy.

METHODSTwo hundred and thirty-six chronic prostatitis patients were divided according to the course of disease into above 6 months group (n = 31) and below 6 months group(n = 205) as well as into sexual disease group(n = 25) and non-sexual disease group(n = 211). An investigation was made by self-rating method on the basis of the National Institutes of Health Chronic Prostatitis Symptom Index(NIH-CPSI) and Symptom Checklist 90 (SCL-90) and 56 cases were rated again after Molida therapy.

RESULTS1. The scores of SCL-90 in 236 prostatitis patients were significantly higher than normal(P < 0.01). The factor scores of SCL-90 showed one-item positive in 107 patients (45.2%), of whom 27 (25.2%) had depressive disorder and 80(74.77%) had anxiety (23 with significant compulsion). Thirty-eight cases(16.1%) were two items positive. 2. The scores of SCL-90 were significantly higher in the > 6 months group of history and the sexual disease group than in the control group (P < 0.01). 3. The scores of NIH-CPSI showed a positive correlation with those of SCL-90 and both scores in 43/56 cases were significantly decreased after psychological treatment (P < 0.01).

CONCLUSIONSThe mood factor plays an important role in aggravating symptoms in chronic prostatis patients and causes difficulty for management. Molida may significantly improve the mood and symptoms of the chronic prostatitis patient.

Adult ; Affect ; Chronic Disease ; Humans ; Male ; Middle Aged ; Prostatitis ; psychology ; therapy ; Psychotherapy

Objective To find out the relationship between family function and quality of life for elderly stroke patients, and offer the reference for establishing the home nursing plan after discharge. Methods Through questionnaire of family care index and the Nottingham Health Profile, we investigated the family function and survival quality for 79 cases of elderly stroke patients. The data were analyzed and evaluated using the statistics methods. Results The survival quality was related to five family functions, which included adaptability (1.62±0.56), intimacy (1.47±0.71), emotion (1.41±0. 65), development (1.34±0.80) and cooperation (1.29±0.69) from higher score to lower score (P < 0. 05 or P < 0. 01). Conclusions The survival quality of elderly stroke patients is related to the family function. Therefore family function assessment and improvement should be emphasized in making home nursing plan after discharge.

OBJECTIVETo compare oncologic outcomes between doublet and triplet adjuvant chemotherapy for gastric cancer patients undergoing radical resection.

METHODSPatients with gastric cancer receiving adjuvant chemotherapy after radical resection from January 2004 to December 2008 were included. Doublet was defined as 5-FU 750 mg/m² (days 1-5) or capecitabine 1000 mg/m² (days 1-14) plus cisplatin 60 mg/m² (day 1) or oxaliplatin 130 mg/m² (day 1), while triplets had epirubicin 50 mg/m² (day 1) added. Chemotherapy was initiated 4-6 weeks after surgery, repeated every three weeks for 6 cycles. Patients were followed-up in the outpatient clinic until death or the most recent follow up(April 30, 2010). Cox proportional- hazard model and Chi-square test were used to test statistical difference.

RESULTSA total of 316 patients (210 received doublets, 106 received triplets) had a median follow-up time of 47 months. Seventy-seven patients died at the end of the follow-up. Two groups were comparable except for age (median age of 57 in doublets, 51 in triplets, P<0.01). The two groups had similar disease-free survival (16 months vs. 23 months, P=0.656) and 3-year overall survival(59.6% vs. 64.8%, P=0.293). There was no significant difference in severe adverse side effects between the two groups (21.9% vs. 30.2%, P=0.107).

CONCLUSIONTriplet adjuvant chemotherapy appears not to be associated with superior efficacy than doublet regimen for patients with gastric cancer after radical resection.

Capecitabine ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Fluorouracil ; administration & dosage ; analogs & derivatives ; Humans ; Male ; Middle Aged ; Postoperative Care ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; drug therapy

OBJECTIVETo evaluate the efficacy and safety of neoadjuvant chemotherapy in patients with locally advanced gastric cancer, and to analyze the relevant factors of recurrent death of gastric cancer after adjuvant chemotherapy.

METHODSClinical data of 49 patients who underwent neoadjuvant chemotherapy for locally advanced gastric cancer between July 2007 and June 2011 were reviewed. Preoperative staging was determined by endoscopic ultrasonography and abdominal computer tomography (CT) or magnetic resonance imaging (MRI). Chemotherapy was administered for regimen of two or three drugs. Prognostic factors were analyzed by univariate and multivariate analysis with Cox proportional hazard model.

RESULTSThe response rate was 33.3% (16/48) and disease control rate was 93.8% (45/48). Forty-four (89.8%, 44/49) patients received curative resection after neoadjuvant chemotherapy, among whom 90.9% (40/44) underwent D2 lymphadenctomy. Thirty-two cases had pathological response and 2 patients had pathological complete response. The average hospital stay was 11.6 days and 2 patients had longer hospitalization because of postoperative pancreatic complications. The toxicities were most in grade 1-2. All the patients were followed up postoperatively and the median follow-up was 21.6 months. Median progression-free survival was 29.6 (95%CI:24.0-35.2) months and median overall survival was 34.6 months (95%CI:29.8-39.4). Imaging response (P=0.038, RR=0.168, 95%CI:0.031-0.904) and pathological response (P=0.007, RR=0.203, 95%CI:0.064-0.642) were identified as independent prognostic factors with COX multivariate analysis.

CONCLUSIONSNeoadjuvant chemotherapy has quite high disease control rate and R0 resecting rate for patients with locally advanced gastric cancer. Imaging response and pathological response are most important prognostic factors in those patients.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Chemotherapy, Adjuvant ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; methods ; Preoperative Care ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms ; drug therapy ; surgery ; Treatment Outcome

Objective To investigate the feasibility of the CT texture analysis (CTTA)in differentiating autoimmune pancreatitis (AIP)from pancreatic ductal adenocarcinoma (PDAC).Methods 25 patients with AIP and 31 patients with PDAC who confirmed by pathological or clinical underwent pretreatment three-phase contrast-enhanced CT were enrolled.Histogram parameters (mean CT values,median CT values,25 th,75 th percentile CT values,skewness,kurtosis,entropy and uniformity)were derived from CT images through texture analysis.The differences of histogram parameters between AIP and PDAC groups were compared.ROC and AUC were used to evaluate the diagnostic efficacy of histogram parameters in differentiating AIP from PDAC.Results The values for mean CT values,median CT values,25 th,75 th percentile CT values and uniformity of AIP were significantly higher than those of PDAC group,while the values for entropy of AIP were significantly lower than those of PDAC group in arterial phase,portal phase,and delay phases (all P＜0.05). There were no significant differences in kurtosis and skewness between AIP and PDAC groups (all P＞0.05).The uniformity in portal phase achieved the optimal diagnostic accuracy in differentiating AIP from PDAC (AUC＝0.973 ),the cutoff value was 0.797,the corresponding sensitivity and specificity were 92% and 9 6.8%,respectively.Conclusion CTTA can be used as a quantitative analysis method for differential diagnosis between AIP and PDAC,providing a reference for clinicians to select therapeutic schedules.