Impact of ultra-low dose CT acquisition on semi-automated RECIST tool in the evaluation of malignant focal liver lesions

PurposeTo compare the evaluation of malignant focal liver lesions (FLLs) using a semi-automated RECIST tool with a standard and an ultra-low dose (ULD) computed tomography (CT) protocol.Materials and methodsThirty-four patients with malignant FLLs underwent two abdominal-pelvic CT examinations one using a standard protocol and one using an ULD protocol. There were 23 men and 11 women with a mean age 64.3 ± 14.4 (SD) years (range: 22–91 years). Dosimetric indicators were recorded, and effective dose was calculated for both examinations. Mean malignant FLL attenuation, image noise and contrast-to-noise-ratio (CNR) were compared. The largest malignant FLL per patient was evaluated using the semi-automated RECIST tool to determine longest axis length, longest orthogonal axis length, volume and World Health Organisation area.ResultsDosimetric values were significantly reduced by −56% with ULD compared to standard protocol. No differences in mean malignant FLL attenuation values were found between the two protocols. Image noise was significantly increased for all locations (P < 0.05) with ULD compared to standard protocol, and CNR was significantly reduced (P < 0.05). On the 34 malignant FLLs analyzed, six semi-automated shapes non-concordant with radiologist's visual impression were highlighted with the software, including one FLL (1/34; 3%) with standard CT acquisition only, three FLLs (3/34; 9%) with ULD CT acquisition only and two FLLs (2/34; 6%) with both CT acquisitions. After manual editing, the concordance of the values of the studied criteria between both acquisitions was good and no significant difference was reported.ConclusionSemi-automated RECIST tool demonstrates good performances using ULD CT protocol. It could be used in routine clinical practice with a ULD protocol for follow-up studies in patients with known malignant FLL.     

乳腺1号方治疗肝郁气滞型乳腺增生病疗效观察

目的 :观察乳腺1号方治疗肝郁气滞型乳腺增生病的临床效果。方法 :将72例肝郁气滞型乳腺增生病患者采用随机数字表法分为治疗组、对照组各36例。治疗组给予自拟乳腺1号方内服外敷,对照组给予乳块消片口服。两组均30 d为1疗程,连服3疗程。观察两组临床疗效和治疗前后血清性激素水平。结果:治疗后治疗组总有效率显著高于对照组,两组之间差异有统计学意义(P0.05)。两组治疗后血清雌二醇(E2)、垂体催乳素(PRL)水平下降,治疗组明显优于对照组(P0.05)。结论 :自拟乳腺1号方内服外敷治疗肝郁气滞型乳腺增生病的临床疗效显著,且不易复发。     

Treatment of onychomycosis with a 1,064-nm long-pulsed Nd:YAG laser

Abstract

Background: There are various treatment modalities of onychomycosis. Of these, however, oral antifungal therapies are complicated by potential drug interactions and systemic effects, and the surgical treatment can result in prolonged pain. Therefore, a new, safe and effective therapy is needed that can improve the aesthetic appearance of the nails. Objective: The purpose of this study was to evaluate the effect of treatment of onychomycosis with a 1,064-nm long-pulsed Nd:YAG laser. Methods: 13 patients (31 toenails, 12 fingernails) received five treatment sessions at 4-week intervals with a 1,064-nm long-pulsed Nd:YAG laser. Parameters for each treatment were 6 mm spot size, 5 J/cm² fluence, 0.3 ms pulse duration and 5 Hz pulse rate. Results: Of the 13 patients, 8 (61.5%) were women and 5 were men. The mean age of the patients was 62. Of the 43 nails, 4 (9.3%) achieved a complete cure (9.3%), 8 had excellent treatment outcomes (18.6%) and 31 had good treatment outcomes (72%). None of the 13 patients experienced any discomfort except for a mild burning sensation and there were no adverse effects. Conclusions: Our results demonstrate that the 1,064-nm long-pulsed Nd:YAG laser could be a safe and effective treatment modality in the management of patients with onychomycosis.     

毛大丁草抗卵清蛋白诱导的小鼠支气管哮喘作用的活性部位筛选

目的 通过卵清蛋白(ovalbumin，OVA)诱导的支气管哮喘小鼠模型，筛选毛大丁草抗哮喘的活性部位。方法 采用D101大孔吸附树脂法对毛大丁草50%乙醇提取物进行分段富集，依次洗脱得到水、60%乙醇、95%乙醇3个洗脱部位。小鼠通过腹腔注射OVA致敏、雾化吸入OVA激发来复制哮喘动物模型，在激发阶段连续6 d进行灌胃给药治疗。采用行为学评分考察不同部位对哮喘行为学的影响，利用酶联免疫吸附法测定血清、肺泡灌洗液(bronchoalveolar lavage fluid，BALF)中IL-5的浓度和血清免疫球蛋白IgE的浓度，采用HE染色对肺组织进行组织病理学评价。结果 模型组小鼠哮喘症状评分升高，血清中IgE和IL-5的水平显著升高，BALF中IL-5的水平显著升高；与模型组比较，60%乙醇段高剂量组小鼠哮喘症状明显改善，血清中IL-5的水平显著降低，BALF中IL-5的水平也显著降低。结合病理学切片观察，60%乙醇段治疗的小鼠较之模型组小鼠肺泡间隔增厚程度降低，血管周围和支气管周围炎症细胞浸润显著减少。结论 毛大丁草50%乙醇提取物的60%乙醇洗脱部位为其抗哮喘的活性部位，其化学成分主要是酚酸类、黄酮类和香豆素类。     

老年慢性阻塞性肺疾病急性期合并肺结核感染的治疗方法及其疗效探讨

目的：探讨老年慢性阻塞性肺疾病(chronic obstructive lung disease，COPD)急性期合并肺结核感染的治疗方法及其疗效。方法：选取2014年2月至2016年2月我院收治的老年慢性阻塞性肺疾病急性期合并肺结核感染的患者92例，根据治疗方式随机分为治疗组和对照组，对照组给予COPD对症支持治疗和抗肺结核治疗，治疗组在对照组基础上加用痰热清，比较两组患者治疗有效率、痰培养阴转率以及肝肾损害情况的差异。结果：治疗组患者治疗后痰培养阴转率(36例，85.71%)与对照组(41例，82.0%)的差异无统计学意义(P>0.05)。两组患者治疗后的症状积分均低于治疗前，且差异具有统计学差异(P<0.05)，治疗组治疗后的症状积分(85.62±11.37)低于对照组(91.25±12.38)，且差异具有统计学差异(P<0.05)。治疗组治疗后痊愈2例(4.76%)，显效26例(61.90%)，有效10例(23.81%)，无效4例(9.52%)；对照组治疗后痊愈1例(2.0%)，显效17例(34.0%)，有效22例(44.0%)，无效10例(20.0%)；治疗组治疗疗效明显优于对照组，且差异具有统计学意义(P<0.05)。治疗组治疗后发生肝肾损害14例，对照组11例，两组患者治疗后肝肾损害发生率的差异无统计学意义(P>0.05)。结论：在不影响痰培养阴转率和不加重肝肾负担的情况下，老年COPD急性期合并肺结核感染患者接受一般性治疗的同时进行中医治疗，其疗效更为显著。     

The use of Mitomycin-C to reduce synechia in middle meatus in sinus surgery: preliminary results

Synechia is the most frequent complication after sinus surgery and has been reported in up to 36% of cases. Several types of materials have been used to reduce the incidence of synechia, including Mitomycin C (MMC).ObjectiveThis prospective study aimed to assess the effectiveness of topical MMC in the prevention of synechia after sinus surgery in humans.MethodsAt the end of surgery, MMC solution (1.0 mg/ml) was topically applied randomly to one of the middle meatuses (MMC group) of 14 patients while saline solution was applied to the contralateral meatus (control group). The author remained blind to the medicated side. Synechiae were classified as partial or total.ResultsThree patients had middle meatus synechia in the MMC group (21.43%) versus nine (64.29%) in the control group (p = 0.054). In the MMC group, all three middle meatus synechia were partial, while in the control group there were four partial (28.57%) and five total (35.71%) cases of synechia (p = 0.025).ConclusionsMitomycin C was not effective in preventing middle meatus synechia, but reduced the probability of total synechia formation.     

The effect of endocardial defibrillator shocks on basic atrial electrophysiology in man. Is post cardioversion atrial electrical 'remodelling' artefact?

AIMS: To determine the effect of an endocardial DC shock on the basic electrophysiology of the human atrium if delivered in sinus rhythm. METHODS AND RESULTS: A 5J endocardial R wave synchronized DC shock was delivered in 10 patients in stable sinus rhythm during ICD implantation for ventricular arrhythmias. There was no prior history of atrial fibrillation. Monophasic action potential duration (APD) and atrial effective refractory periods (AERP) were evaluated before, 1 min post DC shock, and 15 min post shock. These parameters were assessed at basic cycle lengths and at atrial paced cycle lengths of 600 ms and 400 ms at two right atrial sites; mid lateral right atrial wall (MRLA) and the right atrial appendage (RAA). There were no significant differences in APD 90, AERP or atrial refractory dispersion at any site or drive cycle length before, immediately after or 15 min after shock delivery. CONCLUSIONS: There are no significant changes in basic electrophysiological parameters following a DC shock delivered in sinus rhythm in patients with no prior history of atrial fibrillation. This suggests that atrial electrical remodelling occurs as a result of atrial fibrillation and is unrelated to shock artefact.     

九江市消除淋巴丝虫病的研究

目的　总结和分析九江市消除淋巴丝虫病的经验、措施和效果。　方法　采用回顾性调查方法 ,对九江市丝虫病的流行分布情况、丝虫病防治试点研究和控制丝虫病的策略、措施及其效果进行总结和分析。　结果　 1972年前九江市有 11个县区 165个乡、镇流行丝虫病 ,人群微丝蚴率为 14 .85 % (165 2 3 7/ 1112 5 40 ) ,传播媒介为中华按蚊和致倦库蚊。在流行病学调查的基础上 ,开展了微丝蚴染色方法的研究、海群生不同治疗方案治疗丝虫病的疗效及反复查治防治丝虫病的效果等丝虫病防治试点研究 ,确立了消灭传染源为主导的策略 ,采取了反复查治结合重点人群服药的措施。至 1988年省级基本消除丝虫病达标考核 ,人群平均微丝蚴率为 0 .16%。随后采取分层整群监测 ,1989～ 1999年病原学监测 3 4个乡、镇 5 0个村 ,平均微丝蚴率 0 .2 9% (14 0 / 473 2 1) ,2 0 0 0年后病原学和蚊媒监测均未发现人体丝虫感染。2 0 0 1年经省审评组审评 ,达到卫生部消除丝虫病标准。　结论　采取以消灭传染源为主的防治措施以及基本消除丝虫病后的流行病学监测和全民服药、药盐防治 ,可实现消除丝虫病的目标。