Extracorporeal photochemotherapy in mycosis fungoides

Objectives

Extracorporeal photo-chemotherapy (ECP, photopheresis) is an approved treatment modality for mycosis fungoides (MF). Our aim is to present our ECP data for MF.

Hepatic adenomatosis may mimic metastatic lesions of liver with 18F-FDG PET/CT

Hepatic adenomatosis is an uncommon benign neoplasm, with the presence of multiple adenomas (generally more than 4) within the liver. A 52-year-old woman presented with multiple (>10) solid liver lesions detected with abdominal ultrasonography and verified with magnetic resonance imaging (MRI). Subsequently, F-18 FDG PET/CT demonstrated increased uptake in these lesions. Histology revealed hepatic adenomatosis. F-18 FDG PET/CT cannot reliably differentiate hepatic adenomas from malignant processes on the basis of uptake.     

64层螺旋CT泪囊造影在评价泪系病变中的临床应用

目的分析64层螺旋CT泪囊造影表现,评价其临床应用价值。方法回顾分析2007年11月至2010年11月间进行CT泪囊造影检查的33例泪溢患者之影像资料。结果本组33例45眼泪囊造影均获得了成功,根据泪道阻塞的有无及阻塞部位的不同,CT表现可分为4型：Ⅰ型泪道无阻塞（9眼）,泪小管、泪囊、鼻泪管及同侧鼻腔显影;Ⅱ型鼻泪管下段阻塞（11眼）,泪小管、泪囊及部分鼻泪管显影;Ⅲ型鼻泪管上段阻塞（19眼）,泪小管、泪囊显影;Ⅳ型泪囊及以上阻塞（6眼）,仅泪小管显影。结论 CT泪囊造影可直观显示泪道有无阻塞及阻塞部位,有助于治疗方案的选择及预后判断。     

Effects of desflurane and isoflurane on hepatic and renal functions and coagulation profile during donor hepatectomy

We compared the effect of two inhalation anesthetics desflurane and isoflurane on postoperative hepatic and renal functions as well as coagulation profiles in living donors undergoing right hepatectomy. This study was performed on 80 patients who were randomly allocated to group D (desflurane, n = 40) or group I (isoflurane, n = 40) after Faculty Ethics Committee approval. After induction, isoflurane or desflurane was used with air/oxygen for anesthetic maintenance. The isoflurane or desflurane concentration was set at one minimum alveolar concentration (MAC). Remifentanil was infused for analgesia as well as cisatracurium. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), international normalized ratio (INR), albumin, total bilirubin, blood urea nitrogen, creatinine, platelet count, and hemoglobin levels were analyzed preoperatively at end of the operation, and on postoperative days (PODs) 1, 2, 3, 5, 7, and 30. Both AST and ALT differed significantly and continually except on POD 30. AST showed significant elevations from the end of the operation to POD 2 and ALT, from the end of the operation to POD 5 in group I compared with group D. INR was significantly higher from the end of the operation to POD 3 in group I and to POD 2 in group D. At the end of the operation as well as on POD 1 and POD 2, INR was significantly increased in group I compared with group D. Albumin level was significantly lower at the end of the operation in both groups, but it was not different. No patient developed hepatic or renal failure. Our study showed better postoperative hepatic tests and INR using desflurane than isoflurane at equivalent doses of 1 MAC in living donors undergoing right hepatectomy.     

Gemcitabine treatment in patients with inoperable locally advanced/metastatic pancreatic cancer and prognostic factors

Objective. Most patients with pancreatic cancer show an inoperable locally advanced/ metastatic tumour at the time of diagnosis. The present study was aimed at determining the prognostic factors in patients with advanced pancreatic carcinoma treated with gemcitabine. Material and methods. Sixty-seven unresectable or metastatic pancreatic cancer patients treated with gemcitabine were included in the study and a total of 258 cycles of treatment were applied. Results. The overall response rate was 5%. Thirty-one percent of the patients had stable disease, whereas progressive disease was seen in 49%. Clinical benefit response rate was 15%. The median duration of response was 7.3 months. Median progression-free survival was 3 months, while median overall survival was 9 months. Univariate analysis revealed that worse results were found in patients with performance status (PS)?=?2, and in patients with primary tumour location in the body or tail of the pancreas (p<0.05). Multivariate analysis of data revealed that the most important factor was PS of the patient, as the patients with PS?=?2 had worse results than the patients with PS?=?0–1 (p<0.05). Conclusions. Low PS is a negative predictive factor for the survival of patients with advanced pancreatic carcinoma treated with gemcitabine.     

补阳还五汤提取液对Schwann细胞氧化损伤的保护作用

本实验建立了Schwann细胞的体外氧化损伤模型,从对Schwann细胞的抗氧化损伤作用探讨补阳还五汤的疗效机制。用原代培养的Schwann细胞建立氧化损伤模型,将培养细胞分为氧化损伤组,补阳还五汤处理组及正常组:(1)应用MTT方法检测细胞的活性;(2)应用生化技术检测细胞内超氧化物歧化酶(SOD)的含量;(3)采用荧光探针Fluo-3-AM标记细胞,用激光共聚焦显微镜观察H_2O_2对Schwann细胞内游离钙([Ca2+])抗氧化损伤的影响。结果显示:与对照组相比,H2O2处理组细胞活性降低(P<0.01),SOD含量明显减少(P<0.01),而补阳还五汤预处理后细胞内[Ca2+]i升高明显被减弱(P<0.01),细胞存活率明显升高(P<0.01)。以上结果表明补阳还五汤能通过抗过氧化损伤保护Schwann细胞。     

急性脑梗死临床诊断中MRI、多层螺旋CT与数字减影血管造影的比较

目的探讨MRI、多层螺旋CT（MSCT）与数字减影血管造影（DSA）在急性脑梗死临床诊断中的应用。方法对本院2019年3月~2020年12月100例疑似急性脑梗死患者的临床资料进行回顾性分析,所有患者均接受MRI、MSCT及DSA检查,以DSA结果为金标准,分析MRI、MSCT诊断结果与DSA结果的一致性,计算MRI、MSCT诊断急性脑梗死的准确度、特异性、敏感度、阳性预测值、阴性预测值。结果DSA诊断结果显示,100例疑似急性脑梗死患者中,急性脑梗死患者79例,非急性脑梗死患者21例;MRI诊断结果显示,急性脑梗死患者77例,非急性脑梗死患者23例,与DSA诊断结果一致性分析,Kappa值为0.637;MSCT诊断结果显示,急性脑梗死患者71例,非急性脑梗死患者29例,与DSA诊断结果一致性分析,Kappa值为0.524。MRI对急性脑梗死的诊断准确度、敏感度分别为92.00%、93.67%均高于MSCT的82.00%、83.54%（P < 0.05）。MRI对发病24 h内、发病72 h内检出率分别为89.29%、87.50%,高于MSCT的64.29%、70.83%（P < 0.05）。结论MRI、MSCT对急性脑梗死的诊断结果与DSA具有较好的一致性,但MRI诊断优势更加明显,可为临床尽早拟定治疗方案提供参考。     

Correlation of peripheral venous pressure and central venous pressure in kidney recipients

BACKGROUND AND OBJECTIVE: Previous studies in adults have demonstrated a clinically useful correlation between central venous pressure (CVP) and peripheral venous pressure (PVP). The current study prospectively compared CVP measurements from a central versus a peripheral catheter in kidney recipients during renal transplantation. METHODS: With ethics committee approval and informed consent, 30 consecutive kidney recipients were included in the study. We excluded patients who had significant valvular disease or clinically apparent left ventricular failure. For each of 30 patients, CVP and PVP were measured on five different occasions. The pressure tubing of the transducer system was connected to the distal lumen of the central or to the peripheral venous catheter for measurements following induction of anesthesia, after induction, 1 hour after induction, reperfusion of the kidney, and the end of the operation, yielding 150 hemodynamic data points. Each hemodynamic measurement included heart rate, mean arterial pressure, mean CVP, and mean PVP determined at end-expiration. RESULTS: The mean PVP was 13.5 +/- 1.8 mm Hg and the mean CVP was 11.0 +/- 1.5 mm Hg during surgery. The mean difference was 2.5 +/- 0.5 (P < .01). Repeated-measures analysis of variance indicated a highly significant relationship between PVP and CVP (P < .01) with a Pearson correlation coefficient of 0.97. CONCLUSION: Under the conditions of this study, PVP showed a consistently high agreement with CVP in the perioperative period among patients without significant cardiac dysfunction.     

Acute meningoencephalitis due to Brucella: case report and review of neurobrucellosis in children

The involvement of the central nervous system (CNS) in brucellosis is rare and has a broad range of presentations. Subacute and chronic meningoencephalitis are described as the most common neurologic manifestations. We report a six-year-old boy with culture-proven neurobrucellosis who presented with an acute picture of meningoencephalitis. Cerebrospinal fluid (CSF) analysis revealed pleocytosis with slight elevation of protein. The agglutination test titer was elevated in serum and Brucella spp. were isolated from both blood and CSF. He was treated with trimethoprim-sulfamethoxazole plus rifampin and streptomycin. His clinical and laboratory features improved with specific antibiotic therapy and no sequela was observed in the short-term follow-up. Due to protean clinical features, unfamiliarity with the disease can delay the diagnosis in children who are not occupationally exposed. In endemic areas, neurobrucellosis should be considered in the evaluation of patients with unexplained neurologic symptoms.