Objective To evaluate the value of 3.0T susceptibility-weighted magnetic resonance imaging (SWI) in the diagnosis of cerebrovascular malformations. Methods Forty-six patients with cerebrovascular malformations, admitted to our hospital fiom May 2008 to December 2010, were examined with a 3.0T MR scanner. All patients were examined with MRI conventional sequences T1WI,T2WI, 3DTOF, and their results were compared with SWI sequence so as to evaluate the value of SWI in the diagnosis of cerebrovascular malformations.Results Twenty-five patients had arteriovenous malformation (AVM), 10 with cavernous hemangioma, 8 with venous malformations, and 3 with telangiectasis in the 46 patients with cerebrovascular malformations. SWI could delineate all the cerebrovascular malformation lesions, especially small lesions, but could not display all supplying artery in AVM. 3DTOF was a better technique in delineating large AVM lesions. Conclusion SWI is much more sensitive in showing small cerebrovascular malformations; and combined with other MR sequences,clear diagnosis of cerebral vascular malformations can be made by SWI.

Objective To compare the image features of magnetic resonance imaging (MRI) and ultrasound (US) for papillary thyroid carcinoma(PTC).Methods From January 2015 to April 2016,86 consecutive patients underwent surgery and pathologically confirmed PTCs in the People 's Hospital Affiliated to Jiangsu University were selected.All patients received neck US and MRI examination before thyroid surgery .For each case,the US and MRI features emphasized included the echogenic /signal,margin,shape,anteroposterior to transverse diameter ratio (A/T), microcalcifications and lymph node metastasis .Statistical analysis was performed using the χ2 test.Results In the comparison of US and MRI features,A/T≥1(41.9％in US and 62.8％in MRI) and lymph node metastasis(88.0％in MRI;56.0％in US) demonstrated statistically significant differences (χ2 =7.551,P=0.009;χ2 =6.349,P=0.025),and no significant differences were observed in the margin ,shape(P=0.724,P=0.316).Conclusion The MRI features of PTCs included A/T and lymph node metastasis was superior to US .

BACKGROUNDPhotodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) is an emerging technique for the treatment of genital human papillomavirus (HPV)-induced benign and premalignant lesions. We report here in a case series of condyloma acuminata (CA) in pregnancy successfully treated with ALA-PDT.

METHODSFive pregnant patients with CA received three to four times treatment respectively. Patients were followed up for 6 - 23 months after treatment.

RESULTSThe clearance rate of genital warts was 100%. No recurrence was found during the follow-up period. Major adverse events reported were mild erosion, pain, and local edema. All pregnancies resulted in healthy live births without delivery complications.

CONCLUSIONSPDT with topical ALA seems to be safe and effective in the treatment of CA in pregnancy. It demonstrated high clearance rate of warts, was well-tolerated by patients, and showed no adverse effects on mothers or fetuses. ALA-PDT may be an ideal strategy of treatment for pregnant women with CA.

Adult ; Aminolevulinic Acid ; therapeutic use ; Condylomata Acuminata ; drug therapy ; Female ; Humans ; Photochemotherapy ; methods ; Pregnancy

Objective To evaluate the diagnostic performance of preoperative multi b values of DWI and ADC for the prediction of extrathyroidal extension (ETE) of papillary thyroid carcinoma (PTC).Methods Between January 2013 and February 2017,MR images including dynamic contrast-enhanced MR imaging (DCE-MRI) and DWI images of 81 patients diagnosed as papillary thyroid carcinoma in the Affiliated Renmin Hospital of Jiangsu University were retrospectively analyzed.ADC values were measured on solid regions of tumors.The differences of ADC were compared between tumors with total ETE(minimal ETE,extensive ETE) and without ETE by independent-samples t test.Results When b=500 s/mm2,ADC values of PTCs with ETE[(1.27±0.17)× 10-3mm2/s]were significantly lower than those from PTCs without ETE [(2.12±0.72)× 10-3mm2/s,(t=9.126,P=0.000)].ADC values of PTCs with extensive ETE[(1.23±0.17)× 10-3mm2/s] were significantly lower than those from PTCs with minimal ETE[(1.29±0.16)× 10-3mm2/s,(t=1.467,P=0.147)].When b=500 s/mm2,the cutoff value of ADC to discriminate PTCs with and without ETE was 1.530×10-3 mm2/s with a sensitivity of 69.0％,specificity of 93.7％,positive predictive value of 77.6％,negative predictive of 77.5％ and ROC curve area of 0.887.Conclusion ADC values of the solid tumor tissue of PTC with ETE are significantly lower than those of PTC without ETE.DWI may be helpful in the determination of thyroid papillary carcinoma ETE.

Clinical reports on cardiac syndrome X (CSX) have been increasing in recent years. In general, CSX does not increase the cardiovascular mortality, but it can affect the patient's quality of life (QOL) and increase the incidence rates of cardiovascular and cerebrovascular events. Although a variety of drugs and therapies have been utilized in the clinical treatment, the management of CSX still represents a major challenge due to its unclear pathogenesis. It is necessary to explore more effective treatment programs. Many attempts have been made on trials of the Chinese medicine (CM) treatment for CSX and proved that CM has a certain advantage in efficacy to improve clinical symptoms and QOL. CM may provide a new approach for the effective treatment of CSX.
Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; Metabolic Syndrome ; physiopathology ; therapy ; Quality of Life

OBJECTIVENimotuzumab is a humanized monoclonal antibody targeted against epidermal growth factor receptor (EGFR). Recent clinical studies show that patients with malignant gliomas could benefit from nimotuzumab treatment. The aim of the present study was to evaluate the efficacy and side effects of nimotuzumab in combination with chemotherapy for patients with malignant gliomas.

METHODSThe patients received 200 mg of nimotuzumab infusion intravenously over 60 minutes once weekly for the first eight weeks and then once every two weeks until unacceptable toxicity or tumor progression occurred. Individualized chemotherapy was administered based on O(6)-methylguanine-DNA methyltransferase (MGMT) expression and previous chemotherapy responses in combined with nimotuzumab.

RESULTSFourteen patients received a total of 122 times of nimotuzumab ranging from 2 to 20 (median 7.5 times). Combined chemotherapy regimens included: continuous 21-day temozolomide (10 cases), standard 5-day temozolomide (2 cases), teniposide plus cisplatin (1 case), and teniposide plus nimustine (1 case). Partial response (PR) and stable disease (SD) were found in 3 patients (21.4%)and 6 patients (42.9%), respectively. Disease control rate (PR + SD) was 64.3%. The median progression-free survival (PFS) was 4 months (95%CI: 0.7 - 7.3) and PFS at 6 months was 30.6%. The most common toxicities include grade I-II neutropenia (2 cases), thrombocytopenia (2 cases), lymphopenia (1 case), nausea and vomitting (3 case) and asymptomatic transaminase increase (1 case). One patient developed grade IV neutropenia and thrombocytopenia. One patient developed nimotuzumab-related acneiform rash.

CONCLUSIONSNimotuzumab in combination with chemotherapy has moderate activity in patients with malignant gliomas and the toxicities are well tolerable, therefore, worth further investigation.

Adolescent ; Adult ; Antibodies, Monoclonal, Humanized ; administration & dosage ; adverse effects ; therapeutic use ; Antineoplastic Agents, Alkylating ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Astrocytoma ; drug therapy ; Child ; Cisplatin ; administration & dosage ; adverse effects ; Dacarbazine ; adverse effects ; analogs & derivatives ; therapeutic use ; Disease-Free Survival ; Female ; Glioblastoma ; drug therapy ; Glioma ; drug therapy ; Humans ; Infusions, Intravenous ; Male ; Nausea ; chemically induced ; Neutropenia ; chemically induced ; Nimustine ; administration & dosage ; adverse effects ; Teniposide ; administration & dosage ; adverse effects ; Thrombocytopenia ; chemically induced ; Young Adult

Objective To evaluate the effect of PTH gene polymorphisms on bone mineral density (BMD) at multiple skeletal sites in normal females.Methods PTH gene phenotype was determined by PCR-RFLP of restriction enzyme Bst BⅠin 596 females aged (46.3?13.7) years (20-80 years),and PCR products with or without enzymolytic site were considered as genotype B or genotype b respectively.BMDs of the anteropesterior spine (AP) and supine lateral spine (Lat) of lumbar vertebrae (L_1-L_4),femoral neck (FN),total hip (T-hip), Ward's triangle (Ward),Trochanter (Troch),forearm [radius+ulna ultradistal (RUUD) and total area of radius + ulna (RUT) ] were measured by DEXA (QDR4500A).Results (1) Hardy-Weinberg equilibrium was evident for PTH polymorphisms.The frequencies of genotype were BB 0.784,Bb 0.208,bb 0.008 and frequencies of alleles B,b were 0.888 and 0.112 respectively in 596 normal females.Frequencies of BB,Bb,bb genotypes were 0.781,0.210,and 0.009 respectively in 347 postmenopausal women and their frequencies of alleles B,b were 0.886,0.114.No significant difference was found between post- and premenopausal women in genotype frequen- cy.(2) Comparing their BMDs of AP,Lat,FN,T-hip,Ward,Troch,RUUD and RUT,there was no significant difference between BB and Bb genotypes of pre- and postmenopansal women groups.(3) Logistic regression analysis failed to show any statistical difference between normal and osteoporosis women with regard to PTH phenotype.Conclusion PTH gene polymorphism has little effect on BMD in normal females.

OBJECTIVETo study the distribution of human immunodeficiency virus-1 (HIV-1) genotypes in Hubei province.

METHODSEpidemiological survey was carried out to HIV-1 carriers who were identified in Hubei province. HIV-1 env V3-V4, gag P17/24 and the first exon of tat region were amplified by nested-polymerase chain reaction(nPCR) .The sequences were determined, and phylogenetic analyses were then performed.

RESULTS4 HIV-1 strains or circulating recombinant forms (CRFs) were identified in Hubei province with subtype B' the predominant which covered 5 kinds of populations including former blood donors, blood receivers, spouses of the infected people, sex workers and their clients, homosexuals, mainly distributed in the areas with many former blood donors. CRF08-BC and CRF01-AE were found distributed in economically more developed cities or southern area of the province, and the major transmission routes was through sexual contact. Only 1 patient, an injecting drug user, was identified having subtype C.

CONCLUSIONSubtype B' was the main epidemic subtypes in Hubei province while CRF08-BC, CRF01-AE and subtype C were also circulating in the province, indicating the transmission of the disease might to become more complex.

China ; epidemiology ; HIV Infections ; epidemiology ; HIV-1 ; classification ; Humans ; Molecular Epidemiology ; Phylogeny ; RNA, Viral ; genetics ; Sequence Analysis, RNA

Objective To evaluate the diagnostic value of preoperative ultrasonography(US)and magnetic resonance imaging (MRI) for the extrathyroidal extension (ETE) in patients with papillary thyroid carcinoma(PTC).Methods The clinical data of 90 patients with PTC from January 2013 to June 2016 were analyzed retrospectively,and all patients were examined by US and MRI before operation.The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of minimal ETE, extensive ETE and ETE (minimal ETE + extensive ETS) were compared between UC and MRI.Results The diagnostic minimal ETE sensitivity of UC was significantly higher than that of MRI (81.9% vs.60.0%), and there was statistical difference (P<0.05).The diagnostic extensive ETE specificity of MRI was significantly higher than that of UC(80.9% vs.63.5%),and there was statistical difference (P<0.01).The diagnostic ETE sensitivity and NPV of UC were significantly higher than those of MRI(97.4% vs.88.3% and 80.0% vs.50.0%),and there were statistical differences (P<0.05 or <0.01).Conclusions US has a higher sensitivity, compared with MRI for diagnostic minimal ETE.MRI has a higher specificity for diagnostic extensive ETE,compared with US.And US has a higher sensitivity and NPV for diagnostic ETE,compared with MRI.

OBJECTIVETo compare the therapeutic effect of percutaneous cervical disc nucleoplasty (PCN group) and percutaneous cervical discectomy (PCD group) for the treatment of cervical disc herniation.

METHODSA retrospective study was carried out from July of 2002 to December of 2004, and there were 80 cervical disc herniation cases who were operated by PCN (42 cases) or PCD (38 cases). The time of operation, clinical result and the stability of cervical spine after operation were evaluated and compared between 2 groups.

RESULTSAll cases had been followed up from 6 months to 26 months, average (12 +/- 5) months on the PCN group and (12 +/- 4) months on the PCD group, and there was no significant difference on 2 groups (t = -0.06, P = 0.953). All cases had been successfully operated. There was significant difference in the operation time between 2 groups (t = -21.70, P = 0.000). There was significant difference in the pre- and post-operation scores of each group (PCN group: t = 14.05, P = 0.000; PCD group: t = -14.79, P = 0.000). There was no significant difference in 2 groups of the clinical outcomes (z = -0.377, P = 0.706, > 0.05). There was no instability of cervical spine cases in 2 groups after operation (P > 0.05), and the cervical spine stability was no significant difference in pre- and-operation in each group.

CONCLUSIONSPCN and PCD for the treatment of cervical disc herniation achieves good outcomes and no difference on the stability of cervical spine. PCN and PCD is a safe, minimally invasive, short time of operation, less traumatic operation and excellent clinical outcome.

Adult ; Catheter Ablation ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Diskectomy, Percutaneous ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome