RESUMEN

Objective To investigate the multi spiral computed tomography(MSCT)characteristics of intraductal papillary neo-plasm of the bile duct(IPNB)and to distinguish the benign and malignant ones.Methods The MSCT and clinical data of 23 patients with IPNB confirmed by pathology were analyzed retrospectively.According to the pathology,they were divided into benign and malignant groups,including 12 cases of benign group(7 cases with low to medium grade intraepithelial neoplasia,and other 5 cases with high grade intraepithelial neoplasia)and 11 cases of malignant group with invasive carcinoma.All patients underwent plain and tri-phasic enhanced CT scans of upper abdomen.The enhanced scan included arterial phase,portal phase and delayed phase.The location,size,growth mode,enhancement type,invasion and metastasis,bile duct manifestations and bile duct stones were analyzed.Independent sample t-test was used to count the transverse diameter,longitudinal diameter and aspect ratio of tumor.Chi square test was used to compare the difference in other parameters between benign and malignant groups.Results There were no significant differences between benign and malignant IPNB groups in the location of the disease,the transverse diameter of the tumor,the dilatation of the bile duct and the presence of the stones(P>0.05).However,the significant differences in tumor growth mode,tumor longitudinal diameter and aspect ratio,enhancement type,invasion of bile duct wall and bile duct truncation were found(P<0.05).Conclusion Benign IPNB is common,while the IPNB with diffuse growth,progressive enhancement,invasion of bile duct wall and extrabiliary structures,and distant metastasis may indicate malignance,and the final diagnosis depends on the pathology.

RESUMEN

Objective ToevaluatetheimagedifferencesofCTinsubtypepapillaryrenalcellcarcinoma(PRCC).Methods Aretrospective analysisof30multiphaseCTenhancedimagesofPRCCconfirmedbyoperationandpathologyinourhospitalwasperformed,followed byacomparativestudyofCT multistageenhancedperformanceandpathology.Results typeⅠ16cases,typeⅡ14cases,ofwhich 11casesofⅡtypePRCC wereirregularorlobulated,and4casesoftypeⅠshowedlobulated,therewarestatisticallysignificant differencesbetweenthetwogroups(P＝0.003).Venoustumorthrombusin5casesoftypeⅡPRCC,4casesoftypeⅡPRCClymph nodemetastasis,perirenalinvasionin6casesofⅡtypePRCC,but1caseofⅠPRCChadvenousthrombus,perirenalinvasionin2 cases,nocaseoflymphnodemetastasis,therewereobviousdifferencesbetweenthetwogroups(P＝0.044,P＝0.022,P＝0.025). PRCCplainscanCTvalue,CTvalueofexcretoryperiod,CTvalueaddedinthesubstantiveperiod,CTincrementduringexcretionperiod, therewarenosignificantstatisticalsignificancebetweentypetwogroups(P＝0.893,P＝0.169,P＝0.559,P＝0.155).CTvalueof corticalphase,CTvalueinperenchymalphase,CTvalueincrementincarticalphasehadsignificantlydifferencesbetweentwogroups (P＝0.013,P＝0.046,P＝0.008).Conclusion Therearecertaindifferenceintumormorphology,outsideinvasionsignsandenhancement degreebetweentypeⅠandtypeⅡPRCCandⅡtypePRCCispronetoappearperirenalinvasion,tumorthrombusandlymphnode metastasis.CTscanningishelpfulindifferentialdiagnosisofsubtypesofPRCC.

RESUMEN

Objective To discuss MSCT imaging features of adrenal ganglioneuroma ,and to sum up the key points of differential diagnosis .Methods The MSCT manifestations of 8 cases with adrenal ganglioneuroma confirmed by operation and pathology were analyzed combined with relevant literature .Results All adrenal ganglioneuromas were single ,5 cases of right adrenal gland ,3 cases of left adrenal gland ,most tumor density was uniform ,density of soft tissue in 7 cases,speckle calcification was seen in 2 cases.No enhanced or mild enhancement was found in the enhanced posterior artery ,the portal and delayed period showed mild continuous enhancement and line like separation enhancement and encapsulation enhancement .Low density of water samples in 1 case of CT plain scan ,no strengthe-ning at all stages .Conclusion Adrenal ganglioneuroma is rare , the dynamic enhanced performance of MSCT has some characteristics ,and it is beneficial to identify other adrenal tumors .

RESUMEN

Objective To investigate the value of 320-slice CT in diagnosis and intervention treatment of the hepatocellular carcinoma (HCC).Methods Retrospective analysis of 41 patients with HCC was performed,who underwent 320-slice CT three-phase scans and the CTA reconstruct before the transcatheter arterial chemoembolization (TACE).The origins,the distributions and the branches of the abdominal arteries were observed,respectively.Compared to the images of the DSA,the tumor feeding artery and portal vein tumor thrombus (PVTT)were analyzed.Results Compared to the images of the DSA,there was an obvious advantage in diagnosis of small HCC with the diameter <3 cm using the 320-slice CTA.However,there were no significant differences in display of hepatic artery variations,tumor feeding arteries and PVTT between the 320-slice CTA and the DSA.Conclusion The 320-slice CT and the CTA reconstruct can be helpful for more accurate diagnosis and evaluation for HCC,it can be used to direct the intervention treatment for HCC on basis of the images of the tumor feeding artery and PVTT.

RESUMEN

Female patients, 50 years old, have a recurrent unilateral aggravating headache for 5 years. Without runny nose, sneezing, nasal hemorrhage, smell or vision loss. Prefessional examination: there is a visible hoar neoplasm in the right middle nasal meatus With smooth surface and rich in vascular. The nasopharyngeal MRI shows that there is a occupancy lesion in the right nasal cavity and sinuses, well-demarcated, about 21. 5 mm x 25.5 mm x 37.0 mm. Angiofibroma is the most likely diagnosis. Postoperative pathological section shows that tumor are hypercellular, which contains big nucleus. Cells are spindle or short fusiform shape, there are stripes and nuclear division in some cells. There are vortex structures in partial region. Immunohistochemical examination shows: CD34(++), Ki-67 (< 5%), CD68(-), Des (-), NSE(+), S-100(++), SMA(-), EMA (+). Histopathologic diagnosis: atypical meningioma, some were differentiated to rhabdoid meningioma. The final diagnosis is malignant meningioma in nasal cavity and paranasal sinuses.

Asunto(s)

RESUMEN

Objective To evaluate the effect of irbesartan and nifedipine controlled-release tablets on morning blood pressure surge in patients with essential hypertension. Methods Ninety patients with essential hypertension were randomly divided into irbesartan group ( group A, n = 45) and nifedipine group (group B, n =45). Irbesartan tablets 150 mg/d and nifedipine controlled-release tablets 30 mg/d were respectively given in group A and group B for 4 weeks. The levels of diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure ( MAP ) and morning blood pressure surge ( MBPS ) before and after treatment were measured by ambulatory blood pressure monitoring. Results The DBP, SBP, MAP and MBPS levels of two groups after treatment for 4 weeks were all decreased (P < 0.01). All the indexes of group B decreased more significant compared to group A (P < 0.05 ). Conclusion To control blood pressure and prevent morning blood pressure surge, nifedipine controlled-release tablets are better than irbesartan.

RESUMEN

Objective Large-conductance culcium-activated potassium (BKCa) channel modulates vascular smooth muscle tone. In the present study, we tested the hypothesis that salt, one of the factors which significantly influence bleed pressure (BP), can regulate BKCa activity and then elevate blood pressure. Methods Male Spragne-Dawley rats aged 6 weeks were randomized into high salt diet group (HS) and control group, fed with high salt diet (containing 5% NaCi) and standard rat chow (containing 0.4% NaCl) respectively for 16 weeks. Tail systolic blood pressure (SBP), body weight (BW) and 24-hour urinary output were tested every 4 weeks. Content of urinary Na+ was detected using flame spectrophotometrical method. At the end of 16 weeks, all the rats were killed, the mesenteric arteries were obtained, and single mesenteric smooth muscle cells were isolated at once. The resting membrane potential (Em), the total potassium currents and the currents after perfusion with TEA solution of the cells were all recorded by whole cell patch clamp. The transcriptions of BKCa channel α and β1 sobunits in mesenteric arterial vascular smooth muscle cells (VSMC) of each group were calculated by real-time RT-PCR. Results There was no difference in SBP and BW at each stage between control group and HS group; the urinary Na+ level in HS animals was elevated significantly after 4 weeks.The negative values of Em in HS group VSMCs were reduced compared with these in the control group. Transcriptions of β1 subanit of BKCa channels were decreased in HS group, but α subunit transcriptions did not differ between the two groups. Whole cell potassium currents did not differ hetween HS and control groups, but BKCa currents of HS group VSMCs were lower than these of control group ones. Conclusion Even without elevating SBP, salt-loading can still modulate the expression and activity of BKCa channel in the mesenteric arterial VSMC and elevate vascular tone.

RESUMEN

Objective To study the clinical role of the variation of serum matrix metalloproteinase-8 (MMP-8)concentration in patients with acute coronary syndrome (ACS). Methods ELISA method was adopted to detect serum MMP-8 concentration and to observe concentration's differences and features among 80 selected ACS cases (43 acute myocardial infarction and 37 unstable angina pectoris), 43 stable angina pectoris (SAP) cases and 37 control cases.And meanwhile the atherosclerosis risk factors of each case, such as age, sex, hypertension, body mass index, smoking,family history, diabetes, and hyperlipidemia were collected and analyzed as a whole. Results First, serum MMP-8 concentration reached the highest point in ACS, and there was significant difference between SAP and control groups (P<0.01). Second, sermn MMP-8 in AMI was much higher than that in UAP with significant difference (P<0.01). There was no difference between UAP and SAP groups (P>0.05). Third, Logistic regression analysis revealed that serum MMP-8 concentration might be the indicator of ACS (B=4.493, P=0.000), particularly, that of AMI (B=9.961,P=0.000). Fourth, linear correlation and linear regression analysis found that only neutrophil was likely to influence serum MMP-8 concentration (r=0.274, P=0.001). Fifth, in the diagnosis of ACS, the area under ROC curve of MMP-8 was 0.785, the sensitivity and specificity were 68.6% and 76.5%, respectively. Conclusion ① Serum MMP-8 concentration has close relationship with the occurrence of ACS, particularly with AMI;② Serum MMP-8 concentration may be one of the predicting indicators of ACS and particularly of AMI;③ Neutrophil may be correlated with serum MMP-8 concentration;④ MMP-8 is of somewhat valuable in diagnosing ACS.

RESUMEN

0.05).② On diagnosing ACS,the area under ROC curve of sCD40L was 0.773,the sensitivity,specificity and validity are 82.8%,61.9% and 85.7%,respectively,which were all highest among so much indexes.Conclusion High serum sCD40L levels may suggest vulnerable plaque,and it's somewhat valuable in diagnosing ACS.