Objective To evaluate the imaging features of MRI in autoimmune pancreatitis (AIP) and analyze the diagnostic value before and after treatment.Methods MRI data of 20 AIP patients (14 males,6 females;average age:(54.0±10.3) years) from January 2013 to December 2015 were retrospectively analyzed.The sequences of MRI included T1 weighted imaging (WI),T2WI,MR cholangiopancreatography (MRCP),diffusion weighted imaging (DWI) and dynamic enhancement images.Fifteen of the patients received DWI again after hormone therapy.The location and extent of lesions,signal,patterns of dynamic enhancement,"pseudocapsule" sign and other accompanying signs,the apparent diffusion coefficient (ADC) of the lesion and the DWI manifestations before and after treatment were observed,calculated and compared.x2 test and paired t test were used to analyze the data.Results Five patients were confirmed by pathology and 15 by clinical follow-up.In MRI,16 patients appeared diffusive swollen pancreases,and 4 patients were with focal enlargement.Lesions of pancreas showed low signal on T1WI and high signal on T2WI.Twelve patients presented "pseudocapsule" around the lesions and progressive enhance was shown in the delayed phase on dynamic contrast enhanced MRI.Ten patients showed stenotic choledoch in the head of pancreas and segmented stenotic pancreatic duct in MRCP.All pancreatic lesions in the 10 patients presented high signals on DWI.The pancreatic morphology,the signal of the lesion,the "pseudocapsule" sign and the enhancement degree on MRI were significantly improved compared with those before treatment in 15 patients (x2 values:5.000-22.941,all P＜0.05).Mter hormone therapy,the signals on DWI were markedly weakened in pancreatic parenchyma,and ADC was significantly higher than that before treatment ((1.27± 0.14)×10-3 vs (1.05±0.16)×10-3 mm2/s;t=4.15,P＜0.01).Conclusion DWI could reflect the pathological and biological characteristics of AIP and be used to evaluate the therapeutic efficacy of hormone treatment in AIP.

Professor - successively followed famous doctors of acupuncture and spleen-stomach disease, such as -, inherited their academic thoughts and clinical experience, and studied the classics to summarize and propose the clinical academic proposition regulating spleen-stomach differentiating meridians-collaterals. In clinical practice, professor focuses on individual differences of patients, carefully examines syndrome and refines acupoint selection; he pays attention to regulating spleen-stomach, and actively uses Zusanli (ST 36); he simultaneously uses acupuncture-moxibustion and acupoints with efficacy; he inherits traditional reinforcing and reducing methods, and extends the scope of acupoint diagnosis and treatment, while he emphasizes keeping spirit and treating spirit, and the combination of mind and , in order to improve clinical diagnosis and treatment effect.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Male ; Meridians ; Moxibustion ; Spleen ; Stomach

Objective:To evaluate the value of 68Ga-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid (DOTA)-fibroblast activating protein inhibitor (FAPI)-04 PET/CT on assessing different pathological grades in patients with renal fibrosis. Methods:A total of 25 patients (11 males, 14 females; age (39.3±13.9) years) diagnosed with renal fibrosis in the Affiliated Hospital of Southwest Medical University from September 2020 to August 2021 were retrospectively analyzed. All patients underwent renal puncture examination and 68Ga-DOTA-FAPI-04 PET/CT examination. The pathological results of kidney puncture were as the " gold standard" to divide the patients into mild fibrosis (Ⅰ), moderate fibrosis (Ⅱ), and severe fibrosis (Ⅲ). At the same time, 20 patients (10 males, 10 females; age (47.5±13.2) years) who underwent 68Ga-DOTA-FAPI-04 PET/CT examination showed no abnormal uptake of radioactivity in bilateral kidneys and no history of urinary system related diseases were enrolled as normal controls. Parameters including the maximum standardized uptake value (SUV max) of both kidneys, the mean standardized uptake value (SUV mean) of the liver, target/background ratio (TBR), glomerular filtration rate (GFR), and serum creatinine (Scr) were collected. Kruskal-Wallis rank sum test and Bonferroni correction method were used to compare the differences of SUV max, SUV mean, TBR and Scr among groups. One-way analysis of variance and least significant difference (LSD) t test were used to compare the difference of GFR among groups. The receiver operating characteristic (ROC) curve analysis was used to analyze the diagnostic efficacy of SUV max for the degree of renal fibrosis. Results:Of 25 patients, 22 had increased imaging agent uptake and the sensitivity of 68Ga-DOTA-FAPI-04 PET/CT in diagnosing renal fibrosis was 88%. The SUV max and TBR of patients with fibrosis grade Ⅰ, Ⅱ and Ⅲ were significantly higher than those of controls (SUV max: 4.40(3.30, 4.50), 5.90(4.28, 6.48), 8.50(7.50, 9.73) and 1.44(1.38, 1.68); TBR: 6.340±2.389, 8.097±1.420, 11.343±2.002 and 2.986±0.645; H values: 33.685, 32.368, all adjusted P<0.05 (Bonferroni correction method)). The Scr of patients with fibrosis grade Ⅰ and Ⅲ were significantly different (70.1(55.4, 92.5) and 174.1(161.4, 498.2) μmol/L; H=9.770, adjusted P<0.05 (Bonferroni correction method)). The liver SUV mean of patients with renal fibrosis grades Ⅱ and Ⅲ were significantly higher than that of controls (0.673±0.129, 0.751±0.170 and 0.514±0.142; H=15.609, both adjusted P<0.05 (Bonferroni correction method)). The GFR of patients with fibrosis grade Ⅲ had significant differences with grade Ⅰ and Ⅱ ((27.867±15.747), (87.756±31.657) and (63.160±29.556) ml/min; F=8.298, both P<0.05). ROC curve analysis showed that the area under curve was 0.946 7 (95% CI: 0.899 6-0.993 8, P<0.001). Conclusion:68Ga-DOTA-FAPI-04 PET/CT has a certain value in evaluating the degree of renal fibrosis, which can be used as a supplementary examination method for diagnosing renal fibrosis.

ObjectiveTo introduce a fixation technique with the modified levonorgestrel-releasing intrauterine system （LNG-IUS） and evaluate its efficacy in the treatment of adenomyosis patients with previous LNG-IUS expulsion. MethodsA retrospective analysis was done on 22 adenomyosis patients who underwent modified LNG-IUS fixation due to LNG-IUS expulsion at three hospitals from June 2022 to June 2023. The baseline clinical characteristics， operative and postoperative details were collected and analyzed. The Visual analogu scale （VAS） scores and pictorial blood loss assessment chart （PBAC） scores were measured and compared before， 3 and 6 months after the LNG-IUS fixation. ResultsThe mean operative time was （19.51±7.41） min and intraoperative bleeding was （6.71±5.30） mL. Of the patients， 13 were operated under local anaesthesia and the other 9 under intravenous anaesthesia. There were 4 operations performed by a resident doctor， 15 by an attending doctor and 3 by a senior doctor. No intraoperative or postoperative complication was found. The mean follow-up was 11.51 months and no patient had a recurrence of LNG-IUS expulsion during the follow-up period. The mean level of hemoglobin at 1 month after operation was significantly higher than that before （P<0.001）. VAS scores and PBAC scores at 3 and 6 months postoperatively were all improved significantly than those preoperatively （P<0.001）. ConclusionsEffectively preventing the recurrence of LNG-IUS expulsion， modified LNG-IUS fixation is a safe and efficient method for adenomyosis patients with previous LNG-IUS expulsion. Modified LNG-IUS fixation deserves the clinical application due to its easy operation and wide range of use on women.