1.Sonographic characteristic of hepatic lymphoma
Jiawu, LI ; Wenwu, LING ; Lin, MA ; Lulu, YANG ; Ling, LIN ; Yan, LUO
Chinese Journal of Medical Ultrasound (Electronic Edition) 2014;(3):33-37
Objective To investigate the sonographic characteristic of hepatic lymphoma. Methods Fifteen patients with pathological proven hepatic lymphomas (4 primary and 11 secondary hepatic lymphomas) were included in this retrospective study. All the 15 patients underwent conventional B-mode ultrasound examinations. Two patients (one with primary lymphoma and another with secondary lymphoma) underwent contrast enhanced ultrasonography (CEUS). Results In the conventional ultrasonography, hepatic masses were detected in 9 patients (4 primary and 5 secondary lymphomas). No hepatic mass was detected in the remaining 6 patients with pathological proven secondary lymphomas. For the 4 patients with detectable primary masses, 2 had a single mass and 2 had multiple masses. All primary hepatic lymphomas were hypoechoic. For the 5 patients with detectable secondary masses, 2 had a single mass and 3 had multiple masses. The hypoechoic lymphomas were found in 3 patients, while hyperechoic and isoechoic lymphomas were found in the other 2 patients. In the 4 patients with primary hepatic lymphomas, 3 had hepatomegaly, while none of the 4 patients had splenomegaly. In the 5 patients with detectable secondary masses, hepatomegaly was found in 3 patients in whom 2 had splenomegaly and 1 had a plate-shaped hypoechoic region within spleen. For the 6 patients without detectable secondary masses, splenomegaly was found in all 6 patients and hepatomegaly was found in 4 patients. In the spleen of one patient, a plate-shaped hypoechoic region was detected in the B-mode ultrasonography. In the CEUS, the primary lymphoma presented a thick ring region with slight enhancement peripheral to the mass during the hepatic artery phase;while the secondary lymphoma presented the uneven enhancement pattern with a small plate-shaped region unenhanced in its center during the hepatic artery phase. Conclusions In ultrasonography, the patients with hepatic lymphomas commonly present a single or multiple hypoechoic well-deifned hepatic masses, poor blood lfow and uneven enhancement peripheral to the mass during the hepatic artery phase of CEUS. Other sonographic characteristic include hepatomegaly and splenomegaly. No mass is detected in ultrasonography can not exclude the diagnosis of hepatic lymphoma.
2.Formulation Study and Quality Evaluation of Nifedipine Hollow Controlled-release Microspheres
Kunyan WEI ; Shaoqiu HUANG ; Yumeng WEI ; Ting FENG ; Wenwu ZHENG ; Ling ZHAO
China Pharmacy 2017;28(13):1820-1823
OBJECTIVE:To prepare nifedipine (NF) hollow controlled-release microspheres and evaluate the quality. METH-ODS:Solvent diffusion volatilization method was used to prepare microspheres,using comprehensive scores of cumulative release in 2,12,24 h(Q2 h,Q12 h,Q24 h)as indexes,orthogonal test was designed to screen the carrier material ethyl cellulose(EC),poly-vinyl pyrrolidone(PVP)and main drug NF amounts;appearance,particle size distribution,drug loading,floating and cumulative release of the microspheres prepared by optimal formulation were evaluated and compared of in vitro release behavior with imported preparation of Nifedipine controlled-release tablets (Adalat?). RESULTS:The optimal formulation was as follow as NF 3.00 g, PVP 1.60 g,EC 15.65 g. Prepared NF hollow controlled-release microspheres were spherical in shape with particle size distribution of 24-40 mesh and drug loading of 8.66%;24 h floating rate in release medium was 97.93%,Q2 h,Q12 h,Q24 h were 20.49%, 52.90%,91.00%(RSD<10%,n=3). Compared with the imported preparation,similarity factor f2 values of cumulative release were higher than 50,showing in vitro drug-release was consistent with the zero-order kinetic equation (r=0.9993);n of Rit-ger-Peppas equation (r=0.9807) was 0.478. CONCLUSIONS:Prepare NF hollow controlled-release microspheres show similar drug-release behavior with the imported preparation,the drug is released by the combination of diffusion and erosion.
3.Ultrasonographic manifestations of pancreatic neuroendocrine tumors
Jiawu LI ; Wenwu LING ; Qiang LU ; Yan LUO
Chinese Journal of Medical Imaging Technology 2018;34(1):73-76
Objective To observe manifestations of neuroendocrine tumors of pancreas (NETP) in conventional ultrasound and contrast enhanced ultrasonography (CEUS).Methods Imaging features of histopathologically proved NETP in 90 patients were retrospectively analyzed.Results Conventional ultrasound was performed in all 90 patients,while CEUS was performed in 15 patients.Among all 90 cases,single lesion was found in 85 cases,while multiple lesions were found in 5 cases.The tumors located in pancreatic head (n =41),pancreatic body (n =13) or tail (n =36),respectively.The lesions in 81 cases were hypoechoic,8 were complex echoic and 1 was anechoic,with diameters ranged from 0.80 cm to 12.50 cm.Well-defined boundary of lesions were found in 67 cases,and ill-defined boundary of lesions were found in the other 23 cases.Regular shape lesions were found in 64 cases,while irregular shape lesions were found in 26 cases.Color Doppler ultrasound showed abundant tumor blood flow signals in 35 cases.Main pancreatic duct dilatation was found in 14 cases.Among 15 cases underwent CEUS,hyper-enhancement of tumors during the artery phase and slight hyper-enhancement or iso-enhancement during the delayed phase were observed in 9 cases,while slightly hyperenhancement of tumors during artery phase and hypo-enhancement during delayed phase were observed in 4 cases.Slightly hypo-enhancement peripheral to the masses during artery phase and wash-out during delayed phase with plate-shaped regions without enhancement in the center of tumors were observed in 2 cases.Conclusion NETP mainly manifested as well-defined hypoechoic lesions with regular shape in pancreas in conventional ultrasound,hyper-enhancement during artery phase and no obvious wash-out during delayed phase in CEUS.
4.Progresses of functional imaging in assessment of liver function reserve
Tingting QIU ; Lin MA ; Qiang LU ; Wenwu LING ; Yan LUO
Chinese Journal of Medical Imaging Technology 2018;34(2):310-313
Assessment of liver function reserve has important clinical significance,which can be used to decide the safe range of liver resection,to identify the potential liver injury early,to evaluate the treatment effect and to predict the prognosis of middle/end-stage liver diseases.There are a number of methods to assess liver function reserve.The indocyanine green (ICG) elimination test is the most commonly used and widely acknowledged approach for this assessment.With the development of functional imaging,evaluation of liver function reserve can be non-or minimalinvasive,more convenient and accurate.The application of imaging in assessment of liver function reserve and the relationship with ICG elimination test were reviewed in this article.
5.Portal venous velocity ratios in different degrees of portal vein stenosis following 70% partial hepatectomy of rats
Lin MA ; Lulu YANG ; Kefei CHEN ; Hong WANG ; Qiang LU ; Wenwu LING ; Yan LUO
Chinese Journal of Medical Imaging Technology 2018;34(6):812-816
Objective To analyze the changes of portal venous velocity (PVV) ratio (PVVR) in different degrees of portal vein stenosis (PVS) following 70% partial hepatectomy (PH) in rats.Methods According to different surgical methods,102 SD rats were randomly subjected into sham operation rats group (n=6),non PVS group,mild,moderate and severe PVS group (each group n=24).Models of 70% PH without PV ligation were established in non-PVS group,while in PVS groups were produced with partially ligating PV in different degrees following 70% PH.PVV was measured 1,3,7 and 14 days after operation,and PVVR was calculated in PVS groups.Combined with mitotic index (MI) 3 days after operation and liver regeneration degree (LRD) 7 days after operation,the changes of PVVR in different groups were analyzed.Results MI of non-PVS and moderate PVS groups were significantly higher than that of mild PVS group (both P<0.05),while of severe PVS group was significantly lower than that of moderate PVS group (P<0.05).LRD of severe PVS group was significantly lower than that of non PVS and moderate PVS groups (both P<0.05).In non-PVS group,PVV decelerated to the lowest 3 days after operation,and recovered 7 and 14 days.In PVS groups,PVVR decelerated to the lowest 7 days after operation,and recovered until 14 days.PVVR of severe PVS group was significantly higher than that of mild and moderate PVS groups 1 and 3 days after operation (all P<0.05),while there was no statistical differences among PVS groups 7 and 14 days after operation (all P>0.05).Conclusion Ultrasound can well demonstrate blood flow changes of PVS following 70% PH in rats.Changes of PVVR may relate to pathological changes in hepatocytes,the nuclear division and the volume of regenerated liver in rats.
6.Exploration and practice of integrated teaching of "organ system-centered" urogenital system
Wenwu GUI ; Yidi WEN ; Siting LÜ ; Ling ZHAO ; Xuemei ZHANG ; Lianlian WANG
Chinese Journal of Medical Education Research 2022;21(6):673-675
In order to meet the needs of contemporary society for medicine and cultivate high-quality compound medical talents, Chongqing Medical University has carried out the "organ system-centered" urogenital system integration curriculum reform. In the practice of integrated curriculum teaching, students have deepened their systematic understanding of medical knowledge, enhanced their enthusiasm and initiative in classroom learning, cultivated students' logical thinking ability, and improved students' innovative scientific research ability, by reorganizing the curriculum system, rewriting textbooks, improving the teaching environment, forming a teaching team, and reforming teaching methods, which laids the foundation for the further improvement of the medical curriculum.
7.Establishment of layered training system of ultrasound medicine based on physician and sonographer collaboration
Wenwu LING ; Qiang LU ; Yulan PENG ; Jingyi ZHANG ; Xiaofei ZHONG ; Li QIU ; Jibin LIU ; Yan LUO
Chinese Journal of Medical Education Research 2021;20(9):954-957
In order to meet the social demand for ultrasound talents, a layered training system of ultrasound medical talents suitable for China's national conditions has been explored. The department of ultrasound of West China Hospital of Sichuan University has formulated and implemented a "three-layers" ultrasound education and training system in combination with its own reality. The first layer mainly refers mastering the basic ultrasound examination ability mainly through relevant ultrasound theoretical knowledge and basic operation skills training. The second layer is based on the first level to further master the ability of ultrasound diagnosis and differential diagnosis of common and frequently occurring diseases in various systems, and to be capable of engaging in basic ultrasound teaching and scientific research. The third layer means mastering the ability of ultrasound diagnosis, evaluation and interventional diagnosis and treatment of difficult and specialized diseases, grasping the latest development direction of the sub-specialty, and having the ability to engage in ultrasound teaching and clinical research. The results show that the "three-layers" ultrasound education and training system conforms to China's national conditions and is worthy of reference and promotion.
8.Clinical effect of transcatheter arterial chemoembolization combined with microwave ablation versus repeat resection in treatment of recurrent hepatocellular carcinoma
Jun LING ; Wenwu WAN ; Zheng ZENG ; Huihua YAO ; Ou JIANG ; Bing DING
Journal of Clinical Hepatology 2022;38(9):2053-2060
Objective To investigate the clinical effect of transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) (TACE-MWA) versus repeat resection (RR) in the treatment of recurrent hepatocellular carcinoma (RHCC). Methods A total of 178 patients with RHCC who were admitted to The Second People's Hospital of Neijiang from June 2015 to September 2020 were enrolled, and according to the treatment modality, they were divided into RR group with 64 patients and TACE-MWA group with 114 patients. Baseline demographic data, liver function, and tumor conditions before treatment were recorded, and the patients were followed up to October 2021 to compare postoperative overall survival (OS) time and recurrence-free survival (RFS) time between the two groups. Subgroup analysis based on recurrence pattern (recurrence time and tumor size) was performed, and the influencing factors for prognosis were analyzed. The independent samples t -test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data; the Kaplan-Meier method was used for postoperative survival rate, the Log-rank test was used for survival difference analysis, and a multivariate Cox regression analysis was used to investigate independent risk factors for survival. Results The multivariate analysis showed that tumor diameter, alpha-fetoprotein (AFP) level, alanine aminotransferase, albumin, and time to recurrence were independent prognostic factors for OS (all P < 0.05), and AFP level and time to recurrence were independent prognostic factors for RFS (both P < 0.05). For RHCC with late recurrence (> 2 years), there were significant differences between the two groups in median OS (54.0 months vs 36.0 months, χ 2 =6.171, P =0.013) and median RFS (28.0 months vs 21.0 months, χ 2 = 5.211, P =0.022). For RHCC with a tumor diameter of ≤5 cm, there was a significant difference in median OS between the two groups (33.0 months vs 27.0 months, χ 2 =6.447, P =0.011). Conclusion RR has a similar clinical effect to TACE-MWA in RHCC with early recurrence or a tumor diameter of > 5 cm, but RR should be the first choice for RHCC with late recurrence or a tumor diameter of ≤5 cm.