Objective To investigate the incidence of radioactivity uptake in thymus combined with serum thyroglobulin (Tg) increase in differentiated thyroid cancer (DTC) patients after high-dose 131I treatments,in order to discuss the mechanism of thymus iodine uptaking and Tg increasing.Methods Retrospective analysis of the laboratory examinations and 131Iwhole body scan (131I-WBS) images in 316 DTC patients were performed.The radioactivity uptake in thymus and the Tg level were observed.Results Among 316 patients (total 735 case-times),4 patients of 5 cases-times 131I-WBS showed radioactivity uptake in thymus,accounting for 0.68％ (5/735).All the radioactivity uptake in thymus were found by posttreatment 131I whole body scan (Rx-WBS) and after the second radioactive iodine treatment.For 1 of 4 patients,Rx-WBS still showed thymic uptake 131I after the third radioactive iodine treatment.The serum Tg increased in 3 patients (4 caestimes Rx-WBS) of radioactivity uptake in thymus with the Tg level before Rx-WBS was 13.80 μg/L,＞300.00 μg/L,16.40 μg/L,20.60μg/L,respectively.Conclusion In order to avoid the inappropriate administration of radioiodine therapy,thymic uptake should be identified carefully in DTC patients whose radioactivity uptake is only found at the upper mediastinal and combined with serum Tg increase.

OBJECTIVETo examine the extent of hypoxia in oral squamous cell carcinoma and investigate the factors related to the hypoxia.

METHODSAn animal model of oral squamous cell carcinoma was established and single photon emission computed tomography (SPECT) with 99mTc-HL91 used to detect the hypoxia extent of the oral squamous cell carcinoma. The expression of hypoxia inducible factor 1 alpha (HIF-1alpha) was examined by immunohistochemical staining in 42 cases of formalin-fixed paraffin-embed squamous cell carcinoma.

RESULTSThe uptake of 99mTc-HL91 in the tumor tissue was higher than that in normal tissue and had linear relation with the tumor size (P < 0.05). There was no HIF-1alpha expression in the normal oral mucosa. The expression of HIF-1alpha was high in oral mucosa carcinoma and closely related to the differentiation degree of tumor and metastasis of lymph node (P < 0.05).

CONCLUSIONSTumor tissue had broad hypoxic region. HIF-1alpha highly expressed in oral squamous cell carcinoma and may play an important role in carcinogenesis and aggression.

Adult ; Aged ; Aged, 80 and over ; Animals ; Carcinoma, Squamous Cell ; diagnostic imaging ; metabolism ; pathology ; Female ; Humans ; Hypoxia ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Middle Aged ; Mouth Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Pilot Projects ; Tomography, Emission-Computed, Single-Photon ; Xenograft Model Antitumor Assays

Objective To demonstrate various operative approaches to the removal of the tumors involving the anterior skull base and explore the effectiveness of the pericraniai flap in reconstructing the anterior skull base. Methods The clinical data of 47 patients with anterior skull-based tumors were retrospectively reviewed and analyzed: subffontal approach, extended subfrontal approach and combined craniofacial approaches were performed in 7, 8 and 32 patients, respectively; pericranial flap and galeo-pericranial flap were employed in the reconstructing the anterior skull base. Results Tumors were radically resected in 33, subtotally resected in 12 and partly resected in 2 patients with 21.2% overall complication rate. Conclusion The 3 approaches are highly effective in the removal of anterior skull-based tumors. The pericranial flap or galeo-pericranial flap was reliably and effectively used in the reconstructing anterior skull base with minimally complication rate and excellent endurance of postoperative radiotherapy.

OBJECTIVETo compare the position and magnitude of internal target gross volume (IGTV) of primary hepatocarcinoma delineated by three methods based on four-dimensional computed tomography (4D-CT) and to investigate the relevant factors affecting the position and magnitude.

METHODSTwenty patients with primary hepatocarcinoma after transcatheter arterial chemoembolization (TACE) underwent big bore 4D-CT simulation scan of the thorax and abdomen using a real-time position management (RPM) system for simultaneous record of the respiratory signals. The CT images with respiratory signal data were reconstructed and sorted into 10 phase groups in a respiratory cycle, with 0% phase corresponding to end-inhale and 50% corresponding to end-exhale. The maximum intensity projection (MIP) image was generated. IGTVs of the tumor were delineated using the following three methods: (1) The gross tumor volume (GTV) on each of the ten respiratory phases of the 4D-CT image set was delineated and fused ten GTV to produce IGTV10; (2) The GTVs delineated separately based on 0% and 50% phase were fused to produce IGTV(IN+EX); (3) The visible tumor on the MIP image was delineated to produce IGTV(MIP). Twenty patients were divided into groups A and B based on the location of the target center,and were divided into groups C and D based on the tumor maximum diameter. The patients were divided into groups E and F based on the three-dimensional (3D) motion vector of the target center. The position of the target center, the volume of target, the degree of inclusion (DI) and the matching index (MI) were compared reciprocally between IGTV10, IGTV(IN+EX) and IGTV(MIP), and the influence of the tumor position and 3D motion vector on the related parameters were compared based on the grouping.

RESULTSThe average differences between the position of the center of IGTVs on direction of X, Y and Z axes were less than 1.5 mm, and the difference was statistically not significant. The volume of IGTV10 was larger than that of IGTV(IN+EX), but the difference was not significant (t = 0.354, P = 0.725). The volume of IGTV10 was larger than that of IGTV(MIP) but the difference was not significant (t = -0.392, P = 0.697). The ratio of IGTV(IN+EX) to IGTV10 was 0.75 +/- 0.15 and the ratio of IGTV(MIP) to IGTV10 was 0.78 +/- 0.14. The DI of IGTV(IN+EX) in IGTV10 was (74.85 +/- 15.09)% and that of IGTV(MIP) in IGTV10 was (68.87 +/- 13.69)%. The MI between IGTV10 and IGTV(IN+EX), IGTV10 and IGTV(MIP) were 0.75 +/- 0.15 and 0.67 +/- 0.13, respectively. The median of ratio of IGTV(IN+EX)/ IGTV10 was 0.57 in group A versus 0.87 in group B, statistically with a significant difference between the groups A and B (Z = -3.300,P = 0.001). The median of ratio of IGTV(MIP)/IGTV10 was 0.51 in the group A and 0.72 in group B, with a significant difference between the groups A and B (Z = -3.413, P = 0.001). The median of ratio of IGTV(IN+EX)/IGTV10 was 0.79 in group C versus 0.74 in group D, with a difference not significant (Z = -0.920, P = 0.358). The median of ratio of IGTV(MIP)/IGTV10 was 0.85 in group C versus 0.80 in group D, with a non-significant difference (Z = -0.568, P = 0.570). The median of ratio of IGTV(IN+EX)/IGTV10 was 0.87 in group E versus 0.68 in group F, with a significant difference between the two groups (Z = -2.897, P = 0.004). The median of ratio of IGTV(MIP)/IGTV10 was 0.85 in the group E versus 0.81 in the group F, with a non-significant difference (Z = -0.568, P = 0.570).

CONCLUSIONSThe center displacement of the IGTVs delineated separately by the three techniques based on 4D-CT images is not obvious. IGTV(IN+EX) and IGTV(MIP) can not replace IGTV10, however, IGTV(IN+EX) is more close to IGTV10 comparing with IGTV(MIP). The ratio of IGTV10 and IGTV(MIP) is correlated to the 3D motion vector of the tumor. When the tumor is situated in the upper part of the liver and with a 3D motion vector less than 9 mm, IGTV10 should be the best IGTV.

Adult ; Aged ; Carcinoma, Hepatocellular ; diagnostic imaging ; pathology ; Female ; Four-Dimensional Computed Tomography ; Humans ; Image Interpretation, Computer-Assisted ; Liver Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Respiration ; Tumor Burden

OBJECTIVETo explore the pathological basis of diffusion-weighted imaging (DWI) findings in hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).

METHODSDWI was performed in 15 patients with HCC treated by TACE within 24 - 48 hours before II-phase operation. The DWI findings of the liver lesions were analyzed and correlated with pathological findings including macroscopic observation, HE staining and immunohistochemical staining for bFGF.

RESULTS(1) The viable tumor area showed mostly hypersignal intensity (12/15), whereas coagulative necrotic lesions showed hyposignal (8/15) or isosignal intensity (6/15). The ADC values of zones of viable tumor and necrosis in tumor were (1.42 +/- 0.16) x 10(-3) mm(2)/s and (1.58 +/- 0.18) x 10(-3) mm(2)/s, respectively. There was a significant difference of ADC values between the two zones (t = 2.618, P < 0.05). (2) There was a significant difference in ADC values of viable tumor between well and poorly differentiated tumors (t = -2.646, P < 0.05). The distinction of ADC values of the whole tumor was significant among tumors with different degree of necrosis (chi(2) = 7.236, P < 0.05). (3) A negative correlation was observed between bFGF protein expression index and ADC values of viable parts of the tumors in the study group (r = -0.552, P = 0.033).

CONCLUSIONDWI shows certain characteristic features of the HCC after TACE, and can be used to distinguish viable and necrotic tumor tissues in HCC after TACE.

Adolescent ; Adult ; Carcinoma, Hepatocellular ; metabolism ; pathology ; therapy ; Chemoembolization, Therapeutic ; Cisplatin ; administration & dosage ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Fibroblast Growth Factor 2 ; metabolism ; Fluorouracil ; administration & dosage ; Humans ; Iodized Oil ; therapeutic use ; Liver Neoplasms ; metabolism ; pathology ; therapy ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Young Adult

Adult ; Aged ; Bone Marrow Transplantation ; Bone Transplantation ; Female ; Fibula ; transplantation ; Fractures, Bone ; surgery ; Humans ; Lower Extremity ; injuries ; surgery ; Male ; Middle Aged ; Transplantation, Autologous

OBJECTIVETo study the optimum acupuncture treatment program and the mechanism for treatment of cerebral infarction.

METHODSSixty-three cases were randomly divided into 9 groups. The four factors, times of manipulation, the retaining time of the needle, acupuncture instrument and acupoints,and their corresponding three levels were adopted respectively in treatment of each group. Then nerve function defect score and insulin resistance were observed before and after treatment.

RESULTSThe acupoints, the times of manipulation and the retaining time of the needle have significant effects on nerve function defect and insulin resistance (P < 0.01 or P < 0.05), and the acupuncture instrument has a significant effect on insulin resistance (P < 0.01). The choice of acupoints was the most important factor for acupuncture treatment of cerebral infarction.

CONCLUSIONAcupuncture for regulating The Governor Vessel with twice manipulations and retaining the needle for 60 min is optimum treatment program for cerebral infarction. The good regulating effect of acupuncture on insulin resistance is one of the mechanisms of achieving the therapeutic results.

Acupuncture Points ; Acupuncture Therapy ; Cerebral Infarction ; Humans ; Insulin Resistance ; Needles

OBJECTIVETo analyze antiviral effects of telbivudine in patients with chronic hepatitis B.

METHOD72 chronic hepatitis B patients without prior history of antiviral therapy were treated with telbivudine 600mg once daily.

RESULTSAt week 4, 37.5% of the patients achieved undetectable HBV DNA, and 33.3% achieved ALT normalization. At week 108, 87.5% of the patients achieved undetectable HBV DNA, and 91.7% achieved ALT normalization. HBeAg seroconversion occurred in 23.9% of the 46 HBeAg positive patients. The rates of undetectable HBV DNA and HBeAg seroconversion at week 108 in the patients with HBV DNA < 3 log(10) copies/ml at week 12 were significant higher than those in patients with HBV DNA >or= 3 log(10) copies/ml. The rate of undetectable HBV DNA at week 108 in the patients with HBV DNA < 3 log(10) copies/ml at week 24 was significantly higher than that in patients with HBV DNA >or= 3 log(10) copies/ml, and the rate of antiviral resistance rate at week 108 in the patients with HBV DNA < 3 log(10) copies/ml at week 24 was significantly lower than that in patients with HBV DNA >or= 3 log(10) copies/ml. Antiviral therapy could significantly improve Child-Pugh score in patients with liver cirrhosis.

CONCLUSIONTelbivudine treatment results in suppression of HBV and high HBeAg seroconversion, and improvement of Child-Pugh score in the patients with liver cirrhosis.

Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; genetics ; physiology ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Male ; Middle Aged ; Nucleosides ; therapeutic use ; Pyrimidinones ; therapeutic use ; Thymidine ; analogs & derivatives ; Treatment Outcome ; Virus Replication

OBJECTIVETo analyze antiviral effects of entecavir in patients with hepatitis B virus-related cirrhosis.

METHODS104 patients of hepatitis B virus-related cirrhosis with no previous history of antiviral therapy were treated with entecavir 0.5 mg once daily. 37 patients were taken hepatic histologic examination before and after the treatment.

RESULTSMean reductions of serum HBV DNA was 5.1 log10 96 weeks after the treatment, HBV DNA became undetectable in 98.1% patients, and ALT became normal in 80.7% patients; HBeAg seroconversion occurred in 13.9% of the 72 HBeAg positive patients; 61.5% of these patients were infected with genotype C HBV, and 26.9% were infected with genotype B HBV. The genotype of HBV was not associated with the therapeutical effect. Child-pugh score was associated with the progression of the disease: the proportion of patients with disease progression was highest in Child-Pugh C grade patients and lowest in Child-Pugh A grade patients. The level of the HBV DNA load was positively correlated with Knodell HAI score at the baseline and 96 weeks after the treatment.

CONCLUSIONEntecavir treatment results in suppression of HBV replication and delayed progression of fibrosis in patients with hepatitis B virus-related cirrhosis.

Adult ; Alanine Transaminase ; blood ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Female ; Genotype ; Guanine ; analogs & derivatives ; therapeutic use ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; drug effects ; genetics ; isolation & purification ; Hepatitis B, Chronic ; complications ; drug therapy ; virology ; Humans ; Liver Cirrhosis ; drug therapy ; etiology ; virology ; Male ; Middle Aged ; Time Factors ; Treatment Outcome ; Virus Replication ; drug effects

OBJECTIVETo explore the displacement of the selected clips and the center of the geometry consisted of all the clips in the surgical cavity measured on the basis of four-dimensional computed tomography (4D-CT) simulation images.

METHODSFourteen breast cancer patients after breast-conserving surgery were recruited for external beam partial-breast irradiation (EB-PBI), and received large aperture CT simulation. The 4D-CT image data sets were collected when the patient was in the free breathing state. Using the Varian Eclipse treatment planning system, the selected four clips in the cavity were separately delineated on the CT images from 10 phases of the breath cycle, and all of the clips in the cavity were marked to obtain the geometry. Then the displacement of the four selected clips and the center of the geometry in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions were measured. The differences of the displacement were compared.

RESULTSThe displacements in the AP and SI directions were always greater than the displacement in LR direction for the same selected clip. The difference of the displacements in the same direction of the different selected clips was not statistically significant (P>0.05). The displacements of the geometry center consisted of all of the clips in the LR, AP, SI directions were (1.34±0.39) mm, (2.01±1.02) mm and (1.89±1.03) mm, respectively, and the difference of the displacements between LR and AP, LR and SI were all statistically significant (P<0.05). In the same directions (LR, AP and SI), the displacement of geometry center was always greater than the displacement of the selected clips, and the difference except SI direction was all statistically significant (P<0.05). In the SI direction, the association between the displacement of geometry center and the upper clip, geometry center and the lower clip was statistically significant (P<0.05).

CONCLUSIONWhen the target for EB-PBI is defined on the basis of 4D-CT simulation images, the displacement of the selected clips at the border of the surgical cavity is not qualified to substitute the displacement of the target defined basing on all of the clips in the surgical cavity.

Adult ; Breast Neoplasms ; diagnostic imaging ; radiotherapy ; surgery ; Combined Modality Therapy ; Female ; Four-Dimensional Computed Tomography ; Humans ; Mastectomy, Segmental ; Middle Aged ; Radiotherapy, Image-Guided ; Respiration ; Silver ; Surgical Instruments