Objective To compare the MR features of small hepatocellular carcinoma (sHCC) and small intrahepatic mass-forming cholangiocarcinoma (sIMCC) (≤ 3 cm) and improve the accuracy in diagnosis.Methods Imaging studies of 318 patients with 351 sHCCs and 42 patients with 47 sIMCCs were retrospectively reviewed.Signal intensity on T2WI and on each phase of dynamic enhanced imaging,enhancement patterns,and accompanying findings of the two groups were compared by qualitative and quantitative studies.The qualitative imaging features of tumors were compared by the x2 test and the Fisher exact test,and the statistically significant variables obtained from univariate analysis were used to conduct multivariate stepwise logistic regression analysis.Enhancement pattern between sHCCs with elevated AFP and normal AFP were assessed by thex2 test.Results Multivariate analysis indicated that signal features of enhancement pattern and the accompanying findings of tumor capsule and hepatic capsule retraction were key predictors in differentiating sHCC from sIMCC:Wash-out pattern (276/351) with enhanced tumor capsule (275/351) highly indicated sHCC,while progressive enhancement pattern (27/47) with hepatic capsule retraction (8/47) indicated the diagnosis of sIMCC (P ＜ 0.01).Compared with sHCC with normal AFP,atypical patterns as progressive (n =4) and stable enhancement (n =32) were more commonIy seen in lesions with elevated AFP,dynamic enhancement pattern was different between the two subgroups (x2 =8.241,P ＜ 0.05).Conclusions Enhancement patterns and the accompanying tumor capsule and hepatic capsule retraction were the most important predictors in differentiating sHCC from sIMCC.In addition,enhancement pattern was relatively more typical in sHCCs with normal AFP which provided valuable information in diagnosis for clinicians.

Objective To investigate the variations of elastic modulus and hardness of human dentin with aging and location.Methods The non-carious third molars were collected and divided into youth group,middle-aged group and elderly group.Nanoidentation test was conducted on the dentin specimens from multiple regions to test their mechanical properties.Results The elastic modulus and hardness in outer and middle dentin were greater than those in inner dentin;the elastic modulus and hardness increased with the aging in each region of the dentin.Conclusions The dentin shows a gradient mechanical property.The stiffness and hardness in middle and outer dentin are greater than those in inner dentin.The deformation resistance in middle and outer dentin is stronger than that in inner dentin.Meanwhile,elastic modulus and hardness of the dentin increase with the aging.

Objective To investigate the variations of elastic modulus and hardness of human dentin with aging and location. Methods The non-carious third molars were collected and divided into youth group, middle-aged group and elderly group. Nanoidentation test was conducted on the dentin specimens from multiple regions to test their mechanical properties. Results The elastic modulus and hardness in outer and middle dentin were greater than those in inner dentin; the elastic modulus and hardness increased with the aging in each region of the dentin. Conclusions The dentin shows a gradient mechanical property. The stiffness and hardness in middle and outer dentin are greater than those in inner dentin. The deformation resistance in middle and outer dentin is stronger than that in inner dentin. Meanwhile, elastic modulus and hardness of the dentin increase with the aging.

Objective To establish an autoregression moving average (ARMA) model for predicting general traffic accidents and analyzing distributional difference on time series and frequency of common traffic accident so as to provide certain basis for a prediction model with better stability and accuracy. Methods The data of road traffic accidents in one newly developed zone of Chongqing in 2000-2005 were collected. The monthly distribution regularity of road traffic accidents was analyzed with descriptive epidemiologic method. ARMA model was set up for retrospective and prospective prediction. The predicted data were compared. Results Based on the characteristics of monthly distribution, the frequency of general traffic accidents in this area showed a cyclic fashion. The frequency of general traffic accidents predicted by ARMA model had over 80% of coincidence with the actual value. Conclusion The ARMA model can be used to predict the frequency of general traffic accidents, with better accuracy of short-term prediction than the long-term prediction.

OBJECTIVETo investigate the CT and MRI manifestatitions of intraductal papillary mucinous neoplasm (IPMN) of the pancreas.

METHODSBoth clinical and imaging data of 12 pathologically confirmed intraductal papillary mucinous neoplasm, of the pancreas were retrospectively analyzed.

RESULTSThe pancreatic IPMN can be classified into two types based on CT image: the branch duct IPMN (n=7) originated from the head and uncinate process of the pancreas. The tumor consisted of lobulated or clustered small cyst lesions with septa among them, the wall and septa can be enhanced; the combined IPMN (n=5) involved branch ducts of the uncinate process as well as the main pancreatic ducts with dilatation (diameter: 4-7 mm), one of these involved the branch ducts along the pancreatic body. The pancreatic IPMN was mainly found in elderly patient with a chief clinical symptoms of abdominal pain and/or pancreatitis.

CONCLUSIONThe intraductal papillary mucinous neoplasm of the pancreas enjoys specific features in CT and MRI image, which are helpful to the diagnosis.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Pancreatic Ductal ; diagnosis ; diagnostic imaging ; Carcinoma, Papillary ; diagnosis ; diagnostic imaging ; Cystadenocarcinoma, Mucinous ; diagnosis ; diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pancreatic Ducts ; diagnostic imaging ; pathology ; Pancreatic Neoplasms ; diagnosis ; diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

OBJECTIVETo evaluate various kinds of sequences and modified dynamic contrast-enhanced MRI methods in the diagnosis of pancreatic carcinoma.

METHODSForty-nine pancreatic carcinoma patients proved by histopathology or clinical examination and follow-up underwent MR examination. Plain MR sequences included: T1-weighted 2D FLASH, T1 WI 3D VIBE, TSE T2 WI and HASTE with FS. Modified dynamic contrast-enhanced scanning procedures were coronal scaning with 3D FLASH and axial scaning using T1 WI 3D VIBE sequences in turn for the upper abdominal area and pancreatic area. The coronal imaging were used to obtain 3D peripancreatic vessels during arterial phase and portal vein phase scanning, respectively. The axial imaging were used to detect the tumor in pancreatic parenchymal phase and delayed phase scanning, respectively. Final scanning for the whole upper abdomen was performed using T1 WI 2D FLASH axial sequence.

RESULTS(1) Of 49 lesions in these patients, 45 showed hypo-intensity and 4 iso-intensity on 3D VIBE. Forty-six lesions showed hypo-intensity and 3 isointensity on 2D FLASH. On TSE T2 + FS, lesion contour was not clear enough; 3 of them displayed isointensity, the other showed iso- or hyper-intensity. (2) During pancreatic parenchymal phase, 48 lesions showed hypo-intensity and 39 ring enhancement. Twenty-four lesions displayed marginal tubercle and inner compartment enhancement during portal vein and delayed phase. Six lesions showed iso- or hyper-intensity in delayed phase. (3) Thirty-seven patients underwent surgical exploration. MRI and MRA had a good correlation with surgical findings for peripancreatic vessels which were diagnosed as being invasive or noninvasive by tumors except three superior mesenteric arteries and four superior mesenteric veins being misdiagnosed.

CONCLUSIONAs"one-stop-shop" MRI examination, modified MRI sequences consisting of dynamic coronal and axial contrast-enhanced scanning is feasible and helpful in diagnosing, staging and assessing the resectability for pancreatic carcinoma.

Adenocarcinoma ; diagnosis ; pathology ; secondary ; Adult ; Aged ; Aged, 80 and over ; Cholangiopancreatography, Magnetic Resonance ; Female ; Humans ; Image Enhancement ; Imaging, Three-Dimensional ; Liver Neoplasms ; diagnosis ; secondary ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; methods ; Male ; Mesenteric Artery, Superior ; pathology ; Middle Aged ; Neoplasm Invasiveness ; Pancreatic Neoplasms ; diagnosis ; pathology ; Reproducibility of Results ; Sensitivity and Specificity

BACKGROUNDPatient characteristics may be an internal factor influencing patient complaints, but in China patient characterization is restricted to patient satisfaction surveys, and few studies have considered the relationship between patient characteristics and patient complaints. The aim of this research was to determine the reasons for complaints.

METHODSIn this study, we analyzed the characteristics of hospitalized patients and explored their relationship with medical complaints.

RESULTSThe significant factors were age (P = 0.045), hospital cost (P = 0.003), household nature (P < 0.001), and education (P < 0.001). The complaint rate decreased when the patients' age increased (regression coefficient, -0.606; OR, 0.545, and 95%CI, 0.301 - 0.987). The complaint rate increased with an increase in hospital cost (regression coefficient, 0.818; OR, 2.266; and 95%CI, 1.320 - 3.889). Patients from non-agricultural households had a higher complaint rate (regression coefficient, 1.051; OR, 2.861; and 95%CI, 1.611 - 5.082). Patients with higher education levels had lower complaint rates (regression coefficient, -0.944; OR, 0.389; and 95%CI, 0.234 - 0.647).

CONCLUSIONThe survey confirms that older patients and patients with higher education levels had lower complaint rates, while non-agricultural population and patients with higher hospital expenses had higher complaint rates.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Data Collection ; Female ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Patient Satisfaction ; statistics & numerical data ; Young Adult

OBJECTIVETo investigate the role of MRI in evaluating the peripancreatic vessel invasion and resectability of pancreatic carcinoma based on the comparison of MRI image with surgical exploration, and try to establish the criteria for assessment of the sensitivity, specificity and accuracy of resectability.

METHODSForty-one pancreatic carcinoma patients confirmed by pathology received preoperative plain and contrast enhanced MRI scan, and 37 of them had additional coronal MRA scan. Peripancreatic vessel invasion was preoperatively assessed based on MRI features, and the vessel invasion degree from the uninvolved to the severely involved was divided into 6 grades represented by 1, 2a, 2b, 3a, 3b and 4, respectively. Compared with the findings during the surgery, the sensitivity and specificity of each vessel invasion grade were studied and the receiver operator characteristic curve (ROC) was drawn. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of resectability evaluation based on 2 and 2a degree were calculated respectively. The resectability of involved arteries and veins of grade 2 were also analyzed.

RESULTSOf the 41 patients, 22 had resectable tumor, with 20 curative resection and 2 palliative. Compared with the findings during surgery, seven vessels including three arteries and four veins were not correctly interpreted by MRI. If grade 1,2a,2b,3a and 3b was used as the resectable standard,respectively, the sensitivity to predict the unresectbility was 78.3%, 84.8%, 67.4%, 56.5% and 47.8%, respectively. Receiver operator characteristic curve demonstrated that grade 2a was the optimal critical point. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of grade 2a in predicting the unresectbility were 84.8%, 98.5%, 92.9%, 96.6% and 95.9%.

CONCLUSIONOur data showed that grade 2a (tumor involvement < 2 cm long and < 1/2 circumference of the vessel) may be more sensitive and accurate in predicting the resectability, which may be considered as the line of demarcation between the respectable and unresectable cases in clinical practice.

Adult ; Aged ; Carcinoma, Pancreatic Ductal ; diagnosis ; pathology ; surgery ; Celiac Artery ; pathology ; Cholangiopancreatography, Magnetic Resonance ; Female ; Hepatic Artery ; pathology ; Humans ; Image Enhancement ; Magnetic Resonance Imaging ; methods ; Male ; Mesenteric Artery, Superior ; pathology ; Mesenteric Veins ; pathology ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Pancreas ; blood supply ; Pancreatectomy ; methods ; Pancreatic Neoplasms ; diagnosis ; pathology ; surgery ; Portal Vein ; pathology ; Predictive Value of Tests ; Sensitivity and Specificity

Aim To prepare evodiamine butyryl deriva-tive (EBD) and evodiamine butyryl derivative-loaded solid lipid nanoparticles (EBDLN), and study its re-lease in vitro,and to investigate its in situ gastrointesti-nal absorption. Methods EBD was prepared by a one-step synthetized method, and then EBDLN was prepared by a film dispersion method. Dynamic dialy-sis was used to evaluate drug release in vitro,and sin-gle-pass gastrointestinal perfusion was employed to study the gastrointestinal absorption of EDM,EBD and EBDLN. Results In identical release media, there were identical drug release tendencies of EBD and EB-DLN, but the release rate of EBDLN was faster than EBD. Compared with EDM and EBD, the Kavalues and Pappvalues of EBDLN in every perfusion segment increased significantly. The Kaof EBDLN in stomach, duodenum, jejunum, ileum and colon was 110.14-fold,56.70-fold,51.23-fold,45.70-fold and 127.23-fold of free EDM respectively. The Pappvalue of EB-DLN was 9.74-fold, 4.48-fold, 3.82-fold and 11.3-fold of that of free EDM. Conclusion EBDLN has sustained effect and can enhance the gastrointestinal absorption of EDM and EBD.

Objective To compare the MRI features of focal nodular hyperplasia (FNH) and inflammatory hepatocellular adenoma (Ⅰ-HCA),with an aim to improve the diagnostic accuracy in the two lesions.Methods Patients who underwent dynamic-enhanced MRI with histopathologically confirmed FNHs (21 patients with 21 tumors) and Ⅰ-HCAs (10 patients with 12 tumors) were included in this retrospective study.The clinical and the imaging features,including the T2-and T1-weighted,diffusion weighted images,and the dynamic enhanced imagings were analyzed.Results No significant difference was observed in the clinical data between the 2 groups of patients,except in the serum levels of C-reactive protein.The serum C-reactive protein levels were significantly elevated in Ⅰ-HCA than in FNH.Significant differences between patients with FNHs and Ⅰ-HCAs were also found in the morphologic findings and the signal intensities (including shape,centre scar,necrosis,signal intensity of T2WI and DWI,and lesion signal intensity compared to those of the liver in the portal venous phase and delayed phase).The differences in lesion to liver signal in FNH were significantly lower than those in Ⅰ-HCA in the T2WI and the delayed phases.The area under the curve (AUC) for the 2 groups of patients were 0.843 and 0.743,respectively,with no significant difference between them.Conclusions The MRI appearances of atypical FNHs overlapped with Ⅰ-HCA.MRI features of isointensity on T2 Wl and DWI,and isointensity to the liver in the delayed phase were valuable to differentiate FNHs from Ⅰ-HCAs.Most Ⅰ-HCAs showed moderate and marked high signal intensity on T2WI and DWI.These features,when combined with an elevated serum C-reaction protein,necrosis in the lesion and hyperintensity in the delayed phase,were valuable in differentiating Ⅰ-HCAs from FNH.