Objective To study the HRCT features of pneumatized inferior turbinate and to evaluate their diagnostic value.Methods Twelve cases of pneumatized inferior turbinates demonstrated by HRCT were retrospectively analyzed.Results Coronal HRCT could demonstrate pneumatization of the inferior turbinate clearly and directly.Unilateral pneumatization was found in 11 cases and bilateral in one case. According to the location of pneumatization,pneumatized inferior turbinates were classified into three types : bulbous,lamellar,and extensive types.Five of 12 cases were bulbous,5 were lamellar and 2 were extensive type.On coronal HRCT scans,bulbous type showed nodular shape in one case,oval and ellipse shape in 2 cases each,respectively.Lamellar pneumatization appeared as curved stripe-like shape in 4 cases communicating with the maxillary sinus and ellipse shape in one case.Extensive type was found in 2 cases, curled lamella-like shape was found in 1 case communicating with the maxillary sinus and ellipse shape in another case.In 5 cases with maxillary sinus communication,axial HRCT revealed a defect on the medial wall of the maxillary sinus.In such a condition,the maxillary process of palatine bone and maxillary bone attached to the lower turbinate separately.Conclusion HRCT was an optimal imaging modality for the diagnosis of pneumatization of the inferior turbinate and may help the clinicians to differentiate from other causes of the inferior turbinate hypertrophy.

OBJECTIVETo investigate the dynamic expression of placenta growth factor (PLGF) in the lungs with paraquat (PQ)-induced pulmonary fibrosis.

METHODSForty-two adult healthy female Sprague-Dawley (SD) rats were randomly divided into two groups: the control group and the PQ group. Each group was divided into three subgroups, seven animals each. The rats in PQ group were treated intragastrically (ig) with PQ (40 mg/kg) and the rats in control group were treated with the same volume of saline at the beginning of the experiment. The animals of model and control group were sacrificed and lungs were harvested on the 7(th), 14(th) and 28th days respectively. A semiquantitative assay of histological examination and hydroxyproline in lung tissues were used to determine the severity of alveolitis and fibrosis. RT-PCR and immunohistochemistry were used to detect the mRNA and protein expression of PLGF.

RESULTSHydroxyproline contents in lung tissue were significantly increased after PQ administration. Inflammatory cell infiltration and fibrotic scores were more prominent in the model group compared to the control group. Further study showed that PLGF mRNA on day 7, 14 and 28 (1.28 +/- 0.29, 0.80 +/- 0.07, 0.65 +/- 0.13) and positive index of protein expression (2.27 +/- 0.34, 1.78 +/- 0.41, 1.25 +/- 0.69) in the PQ group were all upregulated as compared with those of the control group.

CONCLUSIONThe PLGF expression in the lung tissue in rats with paraquat-induced pulmonary fibrosis is upregulated.

Animals ; Disease Models, Animal ; Female ; Hydroxyproline ; metabolism ; Lung ; metabolism ; pathology ; Paraquat ; poisoning ; Placenta Growth Factor ; Pregnancy Proteins ; genetics ; metabolism ; Pulmonary Fibrosis ; chemically induced ; metabolism ; pathology ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley

Objective To study the CT and MRI findings of osteosarcoma in paranasal sinus and evaluate their clinical value.Methods All 9 cases of osteosarcoma were verified by histopathology.Imaging data were analyzed retrospectively.Results The lesion occurred in maxillary sinus in 5 cases,in ethmoid sinus in 3 cases and in sphenoid sinus in one case.Primary osteosarcoma was found in 7 cases.Secondary osteosarcoma occurred from fibrous dysplasia and ossifying fibroma each in one case.On CT,the involved areas revealed bony destruction associated with ill-defined and irregular soft tissue mass.The lesion showed heterogeneous density with minimal or massive tumor bone formation,cloud-like in 3 cases,ivory-like in 2 cases,spicule-like in 2 cases,cloud- and spicule -like in one case and spicule- and ivory-like in one case.Postcontrast CT showed mild to moderate inhomogeneous enhancement in 3 cases.On MR T_1 WI,the lesions showed hypointensity compared to brain in 5 cases and iso-intensity in 2 cases.On T_2WI,the lesions showed heterogeneous hyperintensity in 4 cases and isointensity in 3 cases with marked hypointense foci which corresponded to tumor bone on CT.Postcontrast MR imaging demonstrated moderate to marked inhomogeneous enhancement in these cases.MRI showed accurately the extent and associated changes of the lesions.The lesions invaded the orbit,pterygopalatine and infratemporal fossae,skull base and extensive craniofacial structures in 5,4,3 cases and 1 case,respectively.Conclusion CT is the optimal modality in showing tumor bone of osteosareoma in paranasal sinus.MRI can demonstrate optimally the invading extent of the lesions.Combined imaging modalities can provide more comprehensive information for diagnosis and therapy of osteosarcoma in paranasal sinus.

Objective To investigate the CT and MRI findings of cavernous hemangioma in paranasal sinus so as to promote the diagnostic accuracy.Methods All 30 cases of cavernous hemangioma in paranasal sinus were verified with pathological examinations.The CT and MRI findings were analyzed retrospectively.Results The lesions occurred in the maxillary sinus in 25 cases,in the anterior ethmoid sinus in 3 cases and in the sphenoid sinus in 2 cases.The lesions extended and compressed adjacent structures.MRI showed the extent and the associated changes of the lesions more clearly compared to CT. On CT,all the involved paranasal sinuses invariably expanded.The bony walls of paranasal sinuses were compressed and remodeled with focal defect in 28 cases,mostly in the medial wall of the maxillary sinus (21 cases).Bony scelerosis of the residual walls of paranasal sinus were found in 8 cases.The lesions demonstrated well-defined margin and heterogeneous density with phlebolith in 10 cases.Postcontrast CT showed marked inhomogeneous enhancement in 16 cases.On MR T_1WI,canernous hemangioma showed hypointense signal compared to brain in 4 cases and isointense signal in 14 cases.On T_2WI,the lesions revealed heterogeneous hyperintense singal in 16 cases and isointense signal in 2 cases with multiple hypointense foci.Postcontrast MR imaging demonstrated marked inhomogeneous enhancement in these cases,honeycomb-like appearance in 8 cases and variegated appearance in 10 cases.The feature of progressive enhancement was found on dynamic contrast enhancement of MRI in 8 cases.Conclusions The characteristic bony change together with phlebolith can suggest the diagnosis of cavernous hemangioma in paranasal sinus on CT.The heterogeneous hyperintense singal on MR T_2WI,progressive enhancement and honeycomb-like or variegated appearance on postcontrast MRI were also the characteristic findings of cavernous hemangioma in paranasal sinus.Combination of CT and MRI findings can provide more accurate information for the diagnosis and therapy of cavernous hemangioma in paranasal sinus.

Objective To understand the variation of thyroid hormones in each trimesters of pregnancy in women.Methods A total of 1 839 pregnant women in different trimesters were enrolled and thyroid hormones including FT3,FT4,TT3, TT4,TSH,TGAb and TPOAb were measured.The reference range of hormone in each trimester was calculated.Results There were statistically differences in all thyroid hormones among all trimesters of pregnancy women (P<0.05 )except for TT4 between the early and middle trimesters (P>0.05 ).The median of FT3 and FT4 were gradually reduced as the pregnant trimester grew up while the median of TSH had the adverse tendency.The median of TT3 was highest during the middle trimester (1.47 nmol/L).TT4 median was lowest during the late trimester (80.67 nmol/L).The TSH level of pregnant women over 30 years old was significantly lower than that of below 30 age group during all trimesters(P<0.05 ). There were significant differences in FT4,TT3 and TT4 level among early and middle trimesters among different ages groups(P<0.05 ).The positive rates of TGAb and TPOAb during late trimester (4.74% and 1.63%)were significantly lower than those of early trimester (1 4.40% and 5.56%)and middle trimester (1 4.40% and 5.56%)(P<0.05 ). Conclusion Significant differences of thyroid hormones are found not only in different stages of pregnancy,but also in different ages.Therefore,establishing trimester-specific reference data of thyroid hormones during different pregnency may be important for clinical practice.

Objective: To identify the maximum tolerated dose (MTD) of docetaxel combined with a fixed dose of cisplatin (75 mg/m 2 ) delivered as hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with ovarian cancer. Methods: In this phase I trial, a time-to-event Bayesian optimal interval design was used.Docetaxel was given at a starting dose of 60 mg/m2 and was increased in 5 mg/m2 increments until the MTD was determined or the maximum dose level of 75 mg/m2 was reached. The doselimiting toxicity (DLT) rate was set at 25%, with a total sample size of 30 patients. HIPEC was delivered immediately following debulking surgery at a target temperature of 43°C for 90 minutes. Results: From August 2022 to November 2022, 30 patients were enrolled. Among the patients who received a dose of docetaxel ≤65 mg/m2 , no DLT was reported. DLTs were observed in one patient who received 70 mg/m2 docetaxel (grade 3 anaemia) and in three patients who received 75 mg/m2 docetaxel (one case of grade 3 anaemia, one case of grade 3 hepatic impairment and one case of grade 4 thrombocytopenia). Patients treated with docetaxel 75 mg/m2 in combination with cisplatin 75 mg/m2 had an estimated DLT rate of 25%, which was the closest to the target DLT rate and was therefore chosen as the MTD. Conclusion Docetaxel, in combination with a fixed dose of cisplatin (75 mg/m2), can be used safely at intraperitoneal doses of 75 mg/m2 in ovarian cancer patients who received HIPEC (43°C, 90 minutes) following debulking surgery.

Objective: To identify the maximum tolerated dose (MTD) of docetaxel combined with a fixed dose of cisplatin (75 mg/m 2 ) delivered as hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with ovarian cancer. Methods: In this phase I trial, a time-to-event Bayesian optimal interval design was used.Docetaxel was given at a starting dose of 60 mg/m2 and was increased in 5 mg/m2 increments until the MTD was determined or the maximum dose level of 75 mg/m2 was reached. The doselimiting toxicity (DLT) rate was set at 25%, with a total sample size of 30 patients. HIPEC was delivered immediately following debulking surgery at a target temperature of 43°C for 90 minutes. Results: From August 2022 to November 2022, 30 patients were enrolled. Among the patients who received a dose of docetaxel ≤65 mg/m2 , no DLT was reported. DLTs were observed in one patient who received 70 mg/m2 docetaxel (grade 3 anaemia) and in three patients who received 75 mg/m2 docetaxel (one case of grade 3 anaemia, one case of grade 3 hepatic impairment and one case of grade 4 thrombocytopenia). Patients treated with docetaxel 75 mg/m2 in combination with cisplatin 75 mg/m2 had an estimated DLT rate of 25%, which was the closest to the target DLT rate and was therefore chosen as the MTD. Conclusion Docetaxel, in combination with a fixed dose of cisplatin (75 mg/m2), can be used safely at intraperitoneal doses of 75 mg/m2 in ovarian cancer patients who received HIPEC (43°C, 90 minutes) following debulking surgery.

Objective: To identify the maximum tolerated dose (MTD) of docetaxel combined with a fixed dose of cisplatin (75 mg/m 2 ) delivered as hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with ovarian cancer. Methods: In this phase I trial, a time-to-event Bayesian optimal interval design was used.Docetaxel was given at a starting dose of 60 mg/m2 and was increased in 5 mg/m2 increments until the MTD was determined or the maximum dose level of 75 mg/m2 was reached. The doselimiting toxicity (DLT) rate was set at 25%, with a total sample size of 30 patients. HIPEC was delivered immediately following debulking surgery at a target temperature of 43°C for 90 minutes. Results: From August 2022 to November 2022, 30 patients were enrolled. Among the patients who received a dose of docetaxel ≤65 mg/m2 , no DLT was reported. DLTs were observed in one patient who received 70 mg/m2 docetaxel (grade 3 anaemia) and in three patients who received 75 mg/m2 docetaxel (one case of grade 3 anaemia, one case of grade 3 hepatic impairment and one case of grade 4 thrombocytopenia). Patients treated with docetaxel 75 mg/m2 in combination with cisplatin 75 mg/m2 had an estimated DLT rate of 25%, which was the closest to the target DLT rate and was therefore chosen as the MTD. Conclusion Docetaxel, in combination with a fixed dose of cisplatin (75 mg/m2), can be used safely at intraperitoneal doses of 75 mg/m2 in ovarian cancer patients who received HIPEC (43°C, 90 minutes) following debulking surgery.

OBJECTIVE: To investigate the clinical characteristics and treatment of pneumocystis carinii pneumonia (PCP) in children with acute lymphoblastic leukemia (ALL), in order to improve the early diagnosis and effective treatment. METHODS: Clinical data of five children with ALL developing PCP in the post-chemotherapy granulocyte deficiency phase were analyzed retrospectively. The clinical manifestations, laboratory tests, imaging findings, treatment methods and effect were summarized. RESULTS: The male-to-female ratio of the five children was 1∶4, and the median age was 5.5 (2.9-8) years old. All patients developed PCP during granulocyte deficiency phase after induction remission chemotherapy. The clinical manifestations were generally non-specific, including high fever, tachypnea, dyspnea, non-severe cough, and rare rales in two lungs (wet rales in two patients). Laboratory tests showed elevated C-reactive protein (CRP), serum procalcitonin (PCT), (1,3)-β-D-glucan (BDG), lactate dehydrogenase (LDH) and inflammatory factors including IL-2R, IL-6 and IL-8. Chest CT showed diffuse bilateral infiltrates with patchy hyperdense shadows. Pneumocystis carinii(PC) was detected in bronchoalveolar lavage fluid (BALF) or induced sputum by high-throughput sequencing in all patients. When PCP was suspected, chemotherapy was discontinued immediately, treatment of trimethoprim-sulfame thoxazole (TMP-SMX) combined with caspofungin against PC was started, and adjunctive methylprednisolone was used. Meanwhile, granulocyte-stimulating factor and gammaglobulin were given as the supportive treatment. All patients were transferred to PICU receiving mechanical ventilation due to respiratory distress during treatment. Four children were cured and one died. CONCLUSION PCP should be highly suspected in ALL children with high fever, dyspnea, increased LDH and BDG, and diffuse patchy hyperdense shadow or solid changes in lung CT. The pathogen detection of respiratory specimens should be improved as soon as possible. TMP/SMZ is the first-line drug against PCP, and the combination of Caspofungin and TMP/SMZ treatment for NH-PCP may have a better efficacy. Patients with moderate and severe NH-PCP may benefit from glucocorticoid.
Caspofungin/therapeutic use* ; Child ; Child, Preschool ; Dyspnea ; Female ; Humans ; Male ; Pneumonia, Pneumocystis/therapy* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy* ; Respiratory Sounds ; Retrospective Studies

OBJECTIVE: To analyze the clinical characteristics and treatment effects of children with acute megakaryoblastic leukemia without down syndrome (non-DS-AMKL). METHODS: The clinical data of 19 children with non-DS-AMKL treated in the Pediatric Hematology Ward in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from May 2008 to April 2018 were analyzed retrospectively. The clinical characteristics, laboratory test and treatment methods of the children were concluded. All patients were followed up to evaluate the effect of treatment. RESULTS: The 19 cases of children included nine male and ten female, the median age of onset was 2 years old. The clinical manifestations showed nonspecific. The median white blood cell of peripheral blood was 15.88×10 CONCLUSION Non-DS-AMKL was rare in children and difficult to be diagnosed. Determination of MICM classification as early as possible was helpful for diagnosis, and genetic testing played an important role for diagnosis and prognosis evaluation. Early hematopoietic stem cell transplantation in patients with CR after chemotherapy might be an effective way to cure AMKL.
Child ; Child, Preschool ; DEAD-box RNA Helicases ; DNA Helicases ; Down Syndrome ; Female ; Humans ; Leukemia, Megakaryoblastic, Acute/genetics* ; Male ; Prognosis ; Retrospective Studies ; Trisomy