Objective To compare various CT signs of pancreatic carcinoma (PC) and inflammatory pancreatic mass (IPM), and to study the diagnostic value of these signs for distinguishing two diseases. Methods Eigty-five patients with PC and IPM were proved by surgery, fine needle aspiration or other comprehensive methods. These patients underwent non-enhanced and enhanced CT scans. CT findings were analyzed retrospectively. The occurrance rates of various CT signs in these two diseases were analyzed with Fisher test and were compared with the corresponding clinical and operational results as welL Results Among the 85 patients, 66 patients were proved to have PC, and 19 were proved to have IPM. In PC group,58 were corerectly diagnosed with CT, 3 (4. 5% ) were misdiagnosed, and 5 (7.6%) were omitted. In IPM group, 9 were correctly diagnosed with CT and 10 (52. 6% ) were misdiagnosed. The CT findings were as follows: (1) Pancreatic mass with liver metastases, lymph node metastases, encased celiac arteries, and cancer emboli in portal veins just occurred in PC group. (2) The occurrence rates of mass over 3 cm in diameter, clear boundary, low-density area within the mass, pseudocysts, peripancreatie infiltration, ascites, and slight and moderate pancreatic-bile duct dilation in PC group were 90. 91% (60/66), 15.15% ( 10/66), 54. 55% ( 36/66 ), 10. 61% ( 7/66 ), 4. 55% ( 3/66 ), 22. 73% ( 15/66 ), 24. 24% ( 16/66 ), 45.45% (30/66), and 27. 27% (18/66) respectively, the occurrence rates in IPM group were 94. 74% ( 18/19), 15.79% ( 3/19 ), 52. 63% ( 10/19 ), 15.79% ( 3/19 ), 15. 79% ( 3/19 ), 21.05% (4/19), 31.58% (6/19) ,21.05% (4/19), and 5.26% (1/19) respectively. There was no statistical difference for these CT findings between two groups(P >0. 05). (3) Pancreatic head mass with atrophy of pancreatic body and tail, mass calcification, pancreatic duct-penetrating sign, pancreatic head mass with hypertrophy of pancreatic body and tail, biliary stones with inflammation , and thickening of pre-kidney fascia in PC group were 48.48% ( 32/66 ), 3.03% ( 2/66 ), 1.52% ( 1/66 ), 10. 61% ( 7/66 ), 6. 06% ( 4/66 ) and 3.03% (2/66) respectively, the occurrence rates of those in IPM group were 5. 26% (1/19),47.37% (9/19), 15.79% ( 3/19 ), 84. 21% ( 16/19 ), 36. 84% ( 7/19 ) and 21.05% ( 4/19 ) respectively. There was statistical difference for these CT findings between two groups ( P < 0. 05 ) . Conclusion Accurate evaluation of various CT signs in PC and IPM is of great importance in the diagnosis of the two diseases.

Objective To identify the metabolic alterations in the prefrontal lobe in male patients with schizophrenia by proton magnetic resonance spectroscopy (~1H-MRS), and to study the relationship between metabolic alterations and executive function. Methods The study was conducted in 26 male schizophrenics with medicine-free for at least 7 days and 28 normal controls. A multi-voxel ~1H-MRS on the prefrontal lobe was performed in all the subjects within 24 hours of admission. Wisconsin Card Sorting Test (WCST) was used to evaluate executive function. The NAA, Cho and Cr were measured and the ratios of NAA/Cr, Cho/Cr and NAA/(Cho+Cr) were calculated. Results Compared with normal controls, the patients demonstrated significantly lower NAA/Cr ratio (t=2.93, P<0.01) in the left prefrontal lobe and poorer performance in WCST (P<0.05). The NAA/Cr ratio in the left prefrontal lobe was positively associated with the responses errors and the perseverative errors of WCST(r=0.45, P＜0.05; r=0.47, P＜0.05)and negatively associated with the categories completed and conceptual level responses(r=-0.54, P＜0.01; r=-0.56, P＜0.01). Conclusions Abnormalities in neuronal function and/or integrity are present in the left prefrontal lobe of male schizophrenics. The neuron damage in the left prefrontal lobe of male schizophrenic may be the primary cause of cognition dysfunction.

Objective To identify the metabolite levels and to study the potential effects of risporidone tablets on prefrontal lobe and thalamus in male first-episode schizophrenia by proton magnetic resonance spectroscopy (1H-MRS).Methods Twenty-two male first-episode schizophrenics were examined at prefrontal lobe and thalamus by multi-voxel 1H-MRS before and after 8 weeks' risperidone tablets treatment,and 30 normal controls were assessed once.The patients were also received positive and negative syndrome scale(PANSS) and Wisconsin card sorting test (WCST) before and after treatment.The N-aeetylaspartate ( NAA ),Choline-congtaining compounds (Cho),and Creatine compounds (Cr) were measured and the ratios of NAA/Cr,Cho/Cr were determined.Results On left prefrontal lobe and left thalamus,the NAA/Cr ratio in patients before treatment demonstrated lower than those in normal controls ( ( 1.37 ± 0.33 ) vs ( 1.61 ± 0.38 ),t =2.57,P ＜ 0.05 ; ( 1.46 ± 0.35 ) vs ( 1.71 ± 0.38 ),t =2.36,P ＜ 0.05 ).There were no significant differences in both the ratios of NAA/Cr and Cho/Cr between pre- and post-treatment (P＞0.05 ).The changes of NAA/Cr on left prefrontal lobe post-treatment were negatively related with the alterations of the total score of PANSS ( r =- 0.46,P ＜ 0.05 ),the score of negative symptoms ( r =- 0.48,P ＜ 0.05 ),the responses errors ( r =- 0.42,P ＜ 0.05 ) and the porseverative errors ( r =- 0.40,P ＜ 0.05 ),meanwhile,positively related with the alterations of the categories completed ( r =0.44,P ＜0.05 ) and the conceptual level responses ( r =0.42,P ＜ 0.05 ).Conclusions Abnormalities in neuronal function and/or integrity presented on prefrontal lobe and thalamus maybe exist in male first-episode schizophrenics.Short-term antipsvchotic treatment with risperidone tablets may have no effects on measures of prefrontal lobe and thalamus.

ObjectiveTo explore the metabolite status on prefrontal lobe and thalamus by proton magnetic resonance spectroscopy (1H-MRS) and affecting factors in patients of schizophrenia.Methods 159 schizophrenics met with CCMD-3 and 45 normal controls were examined at prefrontal lobe and thalamus by multi-voxel 1H-MRS.The N-acetylaspartate ( NAA),Choline-congtaining compounds ( Cho),and Creatine compounds (Cr)were measured and the ratios of NAA/Cr,Cho/Cr were determined. Positive and Negative Syndrome Scale (PANSS),Social Disability Screening Schedule (SDSS),and Wisconsin Card Sorting Test (WCST) were also assessed.ResultsOn left prefrontal lobe of patients,the NAA/Cr ratio demonstrated lower than that in normal controls (1.42 ±0.34 vs.1.64 ±0.39,t =3.70,P＜0.01 ).The same phenomenon were appeared on left thalamus (1.46±0.35 vs.1.66±0.38,t=3.32,P＜0.01) and on right thalamus (1.49±0.34 vs.1.62±0.37,t=2.04,P ＜ 0.05 ).Contributing to the NAA/Cr ratio,main influencing factors on left prefrontal lobe were age of onset,duration of illness,score of negative symptoms,antipsychotic treatment,total score of PANSS,Categories completed of WCST,total score of SDSS,year of education.Main influencing factors on left thalamus were age of onset,duration of illness,antipsychotic treatment.Main influencing factors on right thalamus were duration of illness,age of onset,score of negative symptoms,antipsychotic treatment,and family history.ConclusionsAbnormalities in neuronal function and/or integrity presented on prefrontal lobe and thalamus in schizophrenics are related to many respects,especially age of onset,duration of illness and antipsychotic treatment.

Objective To compare the differences between the schizophrenics with negative and positive symptoms on prefrontal lobe and thalamus by proton magnetic resonance spectroscopy ( 1 H-MRS). Methods 58 negative subtype and 51 positive subtype schizophrenics were examined at prefrontal lobe and thalamus by multivoxel 1H-MRS before antipsychotic treatment The N-acetylaspartate (NAA), choline-containing compounds ( Cho), and creatine compounds (Cr) were measured and the ratios of NAA/Cr, Cho/Cr were determined. Results On right thalamus,the NAA/Cr ratio in negative subtype patients ( 1.40 ± 0.29 ) demonstrated lower than that in positive subtype ( 1.62 ± 0.33 ), the same phenomenon were appeared on male, female, non-first-episode, with-medicine and without-medicine patients (P ＜ 0.05 or 0.01 ). The Cho/Cr ratio on right thalamus in negative subtype of female,non-first-episode,without-medicine schizophrenics were lower than those in positive subtype (P ＜ 0.05 ).On left prefrontal lobe,left thalamus and right thalamus, the NAA/Cr ratios both in negative subtype and positive subtype schizophrenics were significantly negatively related with age of onset(P＜0. 05 or 0.01 ). In negative subtype schizophrenics,the Cho/Cr ratio on right thalamus was positively related with age of onset ( r = 0. 25, P ＜0.05 ). In negative subtype schizophrenics of non-first-episode, without-medicine, the correlation was negative between the NAA/Cr ratio and the course of disease( r= -0.48, -0.46, P＜0.05 ) ,and was positive between Cho/Cr ratio and the course of disease on right thalamus( r= 0.58,0.56, P＜ 0.01 ). Conlusion Compared with positive subtype schizophrenics,negative subtype schizophrenics have greater impairments on 1 H-MRS on right thalamus. The course of disease has greater effects on 1 H-MRS in negative subtype schizophrenics.

Objective To identify the metabolite levels in prefrontal lobe and thalamus in patients of schizophrenia with proton magnetic resonance spectroscopy (1H-MRS). Methods Twenty-six schizophrenics with medicine-free for at least 7 d and 28 normal controls were assessed in this study. All subjects underwent examination of multi-voxel 1H-MRS on prefrontal lobe and thalamus within 24 h. The NAA, Cho and Cr were measured and the ratios of NAA/Cr, Cho/Cr and NAA/(Cho+Cr) were determined. Results Compared with the controls, the NAA/Cr ratio of schizophrenics was significantly lower in left prefrontal lobe and bilateral thalamus (all P＜0.05). No statistical difference of NAA/(Cho+Cr) ratio and the Cho/Cr ratio was found between two groups. Conclusion Abnormalities in neuronal function and/or integrity are present at left prefrontal lobe and bilateral thalamus simultaneously in schizophrenics.

Objective:To explore the clinical efficacy of Gemcitabine in combination with radiotherapy for elderly patients with cervical cancer .Methods:From December 2016 to August 2018, 84 elderly patients with advanced cervical cancer receiving treatment in our hospital were enrolled.As a randomized controlled study, patients were divided into the radiotherapy-alone group and the combined therapy group.Patients in the combined therapy group was given radiotherapy and Gemcitabine.The short- and long-term efficacy, and the rate of adverse reactions were evaluated for the two groups.Results:Tumors in both groups were effectively controlled after treatment.The overall rate of effectiveness in the radiotherapy-alone group was significantly lower than that in the combined therapy group(67.6% vs.87.2%, χ2=4.756, P=0.029). The combined therapy group was associated with a significantly higher survival rate(89.4% vs.59.5%, χ2=10.204, P=0.001), a local recurrence-free rate(83.0% vs.54.1%, χ2=8.286, P=0.004), and a distant metastasis-free survival rate(83.0% vs.56.8%, χ2=6.975, P=0.008), compared with the radiotherapy-alone group.Additionally, the incidence of leukopenia was higher in the combined therapy group than in the radiotherapy-alone group(38.3% vs.13.5%, χ2=8.396, P=0.011). Conclusion:The combination of radiotherapy with Gemcitabine for the treatment of advanced cervical cancer in elderly patients can effectively enhance control on cancerous tissues, improve the long-term survival rate, and reduce the risk of local recurrence.

Objective To evaluate the safety and effectiveness of endoscopic ultrasonography (EUS)-guided ablation with lauromacrogol for pancreatic cystic neoplasms(PCNs). Methods A total of 38 patients with PCNs admitted to Chinese PLA General Hospital from April 2015 to March 2017 were prospectively enrolled to receive EUS-guided ablation with lauromacrogol. Adverse events, such as pancreatitis,fever,bleeding and abdominal pain, were monitored during and after the procedure. Patients were followed up with contrast-enhanced CT or MRI in 3 months,6 months,1 year and 2 year after ablation. Results Thirty-eight patients were enrolled in the study, and 8 of them underwent a second ablation;so, there were 46 treatments. There were 24 females and 14 males with mean age being 53.9±14.7 years. Mild acute pancreatitis occurred in 2 cases and moderate fever occurred in 1 case. The adverse events rate was 6.5%(3/46). Among the 29 patients with complete follow-up of 5 months(2-17 months), the medium tumor volume before operation was 7 564.40 mm3(301.38-87 082.87 mm3)while 542.84 mm3(0-18 202.58 mm3)after the operation(P=0.000). A total of 14 had complete remission(CR)and 8 had partial remission(PR)in 29 patients. The remission effective rate was 48.3%(14/29),40.0%(8/20)in the cysts of the head/uncinate and 66.7%(6/9)in the body/tail(P=0.353). The medium surface area of CR group seemed smaller than that of non-CR group(1 194.27 mm2VS 1 764.09 mm2, P=0.023). Conclusion EUS-guided ablation with lauromacrogol for PCNs is safe and effective. Cysts of smaller surface are more likely to be cured than larger ones.