1.Postoperative recurrence of pelvic solitary fibroma with bladder metastasis: a case report
Shujun YANG ; Duo ZHENG ; Panfeng SHANG ; Zhongjin YUE ; Gongjin WU
Chinese Journal of Urology 2021;42(3):231-232
Solitary fibroma often occurs in the pleura, but rarely outside the pleura. Extrapleural solitary fibroma has atypical clinical symptoms and difficult imaging diagnosis. Here, we report a case of solitary fibroma recurred and metastasized to the bladder after pelvic surgery. He was treated with palliative resection in our hospital. The patient died of systemic metastasis 3 years after operation.
2.Clinical effect of reconstruction of posterolateral hip joint capsule and external rotator muscles in total hip arthroplasty
Zixuan LIU ; Xin ZHANG ; Yuntong ZHANG ; Panfeng WANG ; Yang TANG ; Chuncai ZHANG
Chinese Journal of Trauma 2016;32(6):516-520
Objective To study the efficacy and complications of total hip arthroplasty (THA) with rivet system for reconstruction of joint capsule and external rotator muscles.Methods Data of 170 patients managed with THA of femoral neck fracture between January 2009 and January 2012 were reviewed retrospectively.Hip fracture was the result of a fall and all were subcapital fractures.The fracture patterns were classified as Garden Ⅳ in 139 patients and Garden Ⅱ in 31 patients according to the degree of displacement.In all,85 patients (37 males and 48 females;age between 61 and 84 years,mean 73 years) underwent joint capsule as well as external rotator muscle reconstruction by rivet system (study group).The remaining 85 patients (36 males and 49 females;age between 64-87 years,mean 74 years) were served as control group.The MOS 36-item short form health survey (SF-36),dislocation rate and complications were evaluated at postoperative follow-up.Results Duration of follow-up was 36 to 60 months (mean,46 months).SF-36 questionnaire scale was (45.95 ±4.27)points in study group and (45.38 ± 4.67) points in control group before operation (P > 0.05),while (83.67 ± 3.93) points in study group and (82.16 ± 3.21) points in control group at postoperative follow-up (P < 0.05).Six patients in control group suffered from early prosthetic dislocation,but none in study control.Perioperative incidence of complications was comparable between the two groups (P >0.05).Conclusions Application of rivet system for reconstruction of joint capsule and external rotator muscles in THA of patients with femoral neck fracture can reduce incidence of prosthetic dislocation after operation.The operation is simple and will not increase the rate of perioperative complications.
3.The efficacy of combined procedures for arteriosclerosis obliterations
Fei WU ; Junchao LIU ; Luobo WANG ; Yu DING ; Panfeng LI ; Yang LI ; Bing WANG
The Journal of Practical Medicine 2016;32(8):1308-1310
Objective To explore the treatment of multifocal lower extremity arteriosclerosis oblitera-tions. Methods From March 2014 to September 2014, combined procedures were performed on 30 lower limbs in 30 patients with multifocal lower extremity arteriosclerosis obliterations for revascularization. All the patients underwent endovascular , 20 of whom received endarterectomy , 10 received artery emboloctomy , and 8 received profundaplasty. The rates of technical success and clinical success were observed. The patients were followed up for 6-12 months to observe the total patency rate and rate of limb reservation. Results The technical success rate was 100%. The perioperative complication rate was 30% (9/30). 29 limbs gained improvement with differ-ent degree and the clinical success rate was 96.67% (29/30). The ankle-brachial index elevated 0.37 ± 0.19 on average (P < 0.001). Primary patency rate was 90% and 73% at 6 and 12 months, and 12-month limb reserva-tion rate was 97.67%. Conclusions The combined procedures for complex lower extremity arteriosclerosis oblit-erations have a higher short- to mid-term patency rate and limb reservation rate.
4.Effect of bone marrow mesenchymal stem cells transfected by Zrt/Irt-like protein 1 on adipogenic differentiation via tumor necrosis factor alpha signaling pathway
Xiaoyun ZHANG ; Jinhuan LI ; Zhenzhong YUAN ; Yueping CHEN ; Tian XIA ; Yinghong ZHUO ; Yang FENG ; Jiao LAN ; Panfeng DONG ; Bin ZHAO
Chinese Journal of Tissue Engineering Research 2017;21(13):1986-1991
BACKGROUND:Previous studies have confirmed that ethanol can promote adipogenic differentiation of bone marrow mesenchymal stem cells (BMSCs), and up-regulate the expression of PPARγ and aP2 in the tumor necrosis factor α (TNF-α) signaling pathway. As a member of the ZIP protein family, Zrt/Irt-like protein 1 (ZIP1) is closely related to bone metabolism and osteogenic differentiation.OBJECTIVE:To study the effect of BMSCs transfected by ZIP1 on TNF-α signaling pathway in the process of adipogenic differentiation.METHODS:The BMSCs from rabbits were isolated and cultured under different concentrations of alcohol (0.03, 0.09,0.15, 0.21 mol/L), followed by transfection by ZIP1 siRNA and ZIP1 expression vector.RESULTS AND CONCLUSION:After culture in alcohol, the expression levels of aP2 and PPARγ proteins were both significantly increased (P < 0.05), and the level of triglyceride was increased in all alcohol groups except for 0.03 mol/L alcohol group (P < 0.05). After siRNA transfection, the expression levels of aP2 and PPARγ as well as the level of triglyceride were increased significantly in all the alcohol groups (P < 0.05); however, ZIP1 transfection decreased the expression levels of aP2 and PPARγ proteins (P < 0.05). To conclude, ZIP1 siRNA could promote the adipogenic differentiation of BMSCs through the activation of TNF-α signaling pathway.
5.Clinical Observation of Beraprost Combined with Fibrinogenase in the Treatment of Lower Extremity Athero-sclerotic Occlusive Disease
Qian AN ; Bing WANG ; Wenjun CUI ; Yang LI ; Panfeng LI
China Pharmacy 2017;28(29):4099-4102
OBJECTIVE:To observe the clinical efficacy and safety of beraprost combined with fibrinogenase in the treatment of lower extremity atherosclerotic occlusive disease(LEAOD).METHODS:A total of 82 LEAOD patients selected from our hospital dur-ing Jan. 2015-Jan. 2016 were divided into control group and observation group according to random number table,with 41 cases in each group.All patients received low salt and low fat diet on the basis of treatment for primary disease.Control group was additionally given Fibrinogenase injection 200 U,ivgtt,qd;observation group was additionally given Beraprost sodium tablets 40 μg,tid,after meal,on the basis of control group.Both groups were treated for 15 d.Clinical efficacies as well as hemorheological indexes,ankle-brachial indexes,pain scores,cold felling scores,intermittent claudication scores and serum oxidation stress indexes before and after treatment were compared between 2 groups. The occurrence of ADR was also recorded. RESULTS:Total response rate of observation group (90.24%)was significantly higher than that of control group(78.05%),with statistical significance(P<0.05). Before treatment, there was no statistical significance in above indexes between 2 groups(P>0.05).Compared to before treatment,whole blood high shear viscosity,plasma viscosity,hematocrit,fibrinogen contents,platelet adhesion rates,pain scores,cold feeling scores,intermit-tent claudication scores and serum MDA levels of 2 groups were decreased significantly after treatment;while ankle-brachial indexes, the serum levels of SOD,T-AOC and GSH-Px were increased;the indexes of observation group were better than those of control group,with statistical significance(P<0.05).There was no statistical significance in the incidence of ADR between 2 groups(P>0.05).CONCLUSIONS:Beraprost combined with fibrinogenase show good therapeutic efficacy for LEAOD,can effectively relieve clinical symptoms,promote local blood circulation and improve oxidant stress level with good safety.
6.Familial bilateral pheochromocytoma: a case report
Qian HOU ; Biao ZHANG ; Panfeng SHANG ; Ningqiang YANG ; Yao LUO ; Shujun YANG ; Tianci DU ; Pengyuan WANG ; Chuang LUO
Chinese Journal of Urology 2023;44(1):64-65
Familial pheochromocytoma belongs to autosomal dominant inheritance, and has complex and variable clinical manifestations. A child with bilateral PHEO was admitted to our hospital. His grandmother, father and brother were all diagnosed with PHEO, and his aunt was diagnosed with paraganglioma. The child underwent laparoscopic left partial adrenalectomy and open surgery for the contralateral tumor, and was in good postoperative condition. The blood pressure returned to normal and there was no local recurrence and metastasis during the follow-up of 8 months after the second operation.
7.Feasibility study for calculating size-specific dose estimates based on weight and body mass index in CT abdomen-pelvic examination of adult population
Jian XU ; Xiangquan WANG ; Panfeng YANG ; Yelei XIE ; Kuangnan LUO ; Dewang MAO
Chinese Journal of Radiological Medicine and Protection 2020;40(7):549-553
Objective:To explore the feasibility for taking weight and body mass index (BMI) to calculate the size-specific dose estimate (SSDE) in abdomen-pelvis CT examination.Methods:512 adult patients undergoing abdomen-pelvis CT examination were retrospectively analyzed. The in-house software based on MATLAB platform were used to calculate automatically water equivalent diameter ( dw), size-dependent conversion factor ( f), SSDE, together with their respective averaged values. The correlations between age, height, weight and BMI with dw were calculated by using Spearman correlation analysis. Two regression equations were established to calculate the SSDE (SSDE weight, SSDE BMI), one for the correlation of weight with dw based on first half of these cases and the other for that between BMI with dw based on another half as the cases to be verified. With reference of the SSDE derived from the in-house software, the averaged relative differences and root-mean-square errors in SSDE weightand SSDE BMI were calculated, respectively. Results:No statistically significant correlation between age and d w ( P>0.05) was shown, but weak correlation between height and dw( r=0.260, P<0.05), strong correlation between either weight or BMI with dw( r=0.879, 0.851, P<0.05). Two regression equations were described as dw=13.808+ 0.184×weight, dw=11.142+ 0.618×BMI. The mean SSDE, SSDE weight and SSDE BMI for the verified patients were (13.55±1.66) mGy, (13.84±2.03) mGy and (13.83±2.02) mGy, respectively. As compared to actual SSDE, the averaged relative differences in SSDE weight and SSDE BMI were 1.97% and 1.87%; 0.38% and 2.75% for male patients; 4.58% and 0.43% for female patients; 0.11% and 3.32% for patients with BMI<18.5 kg/m 2;1.92% and 2.06% for those with 18.5 kg/m 2≤BMI<24.0 kg/m 2;2.57% and 1.57% for those with 24 kg/m 2≤BMI<28.0 kg/m 2;3.28% and -1.36% for those with BMI≥28.0 kg/m 2. The averaged root-mean-square errors in SSDE weight and SSDE BMI were both 0.80 mGy; 0.65 and 0.67 mGy for male patients; 0.98 and 0.59 mGy for female patients; 0.73 and 1.03 mGy for underweight, 0.74 and 0.66 mGy for normal weight, 0.85 and 0.79 mGy for overweight, and 1.10 and 1.32 mGy for obesity. Conclusions:Weight and BMI can be used as the surrogate dw to compute SSDE in adult abdomen-pelvis CT examination. However, Weight rather than BMI is more applied to male patients, and BMI is more suitable for female patients.
8. Role of whole-body diffusion weighted imaging (WB-DWI) in the diagnosis and monitoring of newly diagnosed multiple myeloma
Panfeng WANG ; Yongchao LI ; Yang XU ; Ximing WANG ; Liang GUO ; Chengcheng FU
Chinese Journal of Hematology 2017;38(2):129-133
Objective:
To explore the practical value of whole-body diffusion weighted imaging (WB-DWI) in the diagnosis and monitoring of newly diagnosed multiple myeloma (MM) patients.
Methods:
The clinical data of 107 newly diagnosed MM patients at hematology department of the first affiliated hospital of Soochow’s University from September 2012 to January 2016 were retrospectively analyzed. The results of all the 60 patients who were performed WB-DWI before treatment were analyzed. And the role of WB-DWI in the diagnosis and monitoring MM was discussed.
Results:
Of 60 patients, 57 were found to have more or less abnormal foci of osteoclasia by WB-DWI with the positive rate of 95.0% (57/60) . Myeloma related bone lesions occurred predominantly in the axial skeleton, which were commonly seen in ribs, spines and pelvis. There were 96.5% (55/57) patients who had osteolytic rib lesions. And the ribs were the most vulnerable organs. Thirteen patients who had no osteoclasia by computerized tomography (CT) examination were detected abnormal limited diffuse lesions by WB-DWI. Eight patients underwent more than one follow-up WB-DWI. The mean apparent diffusion coefficient (ADC) values of the maximal lesions from all eight patients before and after treatment were 0.984×10-3mm2/s and 1.142×10-3mm2/s, respectively. They were both higher than the normal range [ (0.516±0.180) ×10-3mm2/s]. Mean ADC values of the maximal lesions after treatment were higher than that before treatment. The results of WB-DWI after the induction chemotherapy were consistent with clinical therapeutic effect.
Conclusions
WB-DWI has an important value in the diagnosis and monitoring of newly diagnosed MM. It has higher sensitivity than than that of CT. The results of WB-DWI after induction therapy has a nice correlation with treatment effect and it could monitor the disease.
9.Study on pravastatin for improving carotid atherosclerosis in patients type 2 diabetes mellitus complicating hypertension
Jingyu LIU ; Panfeng HE ; Hui HE ; Li ZHANG ; Qiang LIU ; Jian ZHOU ; Mingsheng ZHAO ; Jing LU ; Wei ZHONG ; Yang WANG ; Li KANG
Chongqing Medicine 2017;46(35):4946-4948
Objective To explore the effect of pravastatin on carotid atherosclerosis in the patients with type 2 diabetes mellitus (T2DM) complicating hypertension.Methods One hundred and six patients.with T2DM complicating hypertension treated in this hospital from April 2015 to April 2016 were selected and divided into the conventional treatment group (n=52) and pravastatin group (n=54).The patients of conventional treatment group were given the conventional therapy of diet control,reducing blood glucose,controlling hypertension,symptomatic and support treatment,while on the basis of conventional therapy the patients of pravastatin group were added with pravastatin.The carotid intima-medial thickness (IMT),detection rate of carotid atherosclerotic plaque and carotid plaque score were measured by ultrasound before and after the treatment in all cases.Meanwhile the levels of serum lipid and hyper sensitive C reactive protein (hs-CRP) were determined.Results The above indicators in the conventional treatment group had no statistically significant difference between before and after treatment (P>0.05),but the IMT value,detection rate of carotid atherosclerotic plaque and carotid plaque score after treatment in the pravastatin group were decreased compared with before treatment,the levels of serum total cholesterol (TC),triacylglycerol (TG),low density lipoprotein cholesterol (LDL-C) and hs-CRP were also significantly reduced compared with before treatment,the differences were statistically significant (P<0.05),moreover the above indicators after treatment in the pravastatin group were remarkably lower than those in the conventional treatment group (P<0.05).There was no statistically significant difference in the incidence rate of adverse reactions between the two groups (P>0.05).Conclusion Pravastatin can effectively and safely improve the carotid atherosclerosis degree in the patients with T2DM complicating hypertension.
10.Feasibility of coronary artery calcium scoring assessment with ultra-low-dose chest CT combined with a calcium-aware algorithm
Huawei XIAO ; Xiangquan WANG ; Panfeng YANG ; Ling WANG ; Jian XU
Chinese Journal of Radiological Medicine and Protection 2023;43(10):820-826
Objective:To evaluate the feasibility of coronary artery calcium (CAC) detection, quantification and risk classification using ultra-low-dose chest CT (ULD-CT) combined with a calcium-aware algorithm.Methods:A total of 115 patients were prospectively enrolled from April to October 2022 at Zhejiang Provincial People′s Hospital, who underwent a standard calcium scoring CT (CACS-CT) scan followed by an additional ULD-CT scan. CACS-CT adopted a prospective ECG-triggered sequence scan with a tube voltage of 120 kVp, and the reconstruction algorithm with Qr36 (group CACS-CT Qr). ULD-CT adopted non-ECG-triggered high-pitch scan with a tube voltage of Sn 100 kVp, and the standard algorithm Qr36 (group ULD-CT Qr) and calcium-aware algorithm Sa36 (group ULD-CT Sa) were respectively used to reconstruct two groups of images. Taking the CAC detection of CACS-CT as a reference, the accuracy of ULD-CT for detecting CAC was calculated, and kappa was used to evaluate the agreement of CAC detection between scanning protocols. The agreement of CACS quantification between scanning protocols was assessed using intraclass correlation coefficients (ICC) and Bland-Altman plots, and the agreement of risk classification between scanning protocols was assessed using weighted kappa. Results:The CAC was found in 66.96% (77/115) of patients in CACS-CT Qr. Taking the CAC detection in CACS-CT Qr as a reference, the sensitivity of CAC detection in ULD-CT Qr and ULD-CT Sa was 96.1% and 97.4%, respectively, and the specificity was 94.73% (k= 0.902, 0.921). The CACS for ULD-CT Qr and ULD-CT Sa was lower than that for CACS-CT Qr (3.6, 6.2 vs. 8.5; P< 0.001), but strongly correlated with CACS for CACS-CT Qr ( r= 0.983, P< 0.001). The mean difference in CACS for ULD-CT Sa and CACS-CT Qr was smaller (12.33), and the agreement was better (ICC= 0.992). The agreement of risk classifications between ULD-CT Sa and CACS-CT Qr was relatively high (weighted k= 0.936), and the reclassification rate (6.08%) was relatively low. The effective radiation dose for ULD-CT was reduced by approximately 77.22% compared with that for CACS-CT. Conclusions:It is feasible to evaluate CACS using Non-ECG-triggered ULD-CT combined with a calcium-aware algorithm.