ObjectiveTo compare the curative effect of levetiracetam combined with lamotrigine and sodium valproate on postoperative patients with temporal lobe epilepsy. MethodsA total of 186 postoperative patients with temporal lobe epilepsy during August 2012 to August 2014 in our hospital were divided into levetiracetam combined with lamotrigine group (n=98), and sodium valproate group (n=88) based on postoperative different antiepileptic drugs treatment. Antiepileptic treatment were followed up for 12~48 months.Curative effect and adverse reaction were observed. Reservation rates and incidence rates of adverse reaction were calculated in the two groups. ResultsIn levetiracetam combined with lamotrigine group, EngelⅠratio was 72.4%(71), EngelⅡratio was 17.3%(17), EngelⅢratio was 7.1%(7), and EngelⅣratio was 3.2%(3);in sodium valproate group, EngelⅠratio was 67.0%(59), EngelⅡratio was 21.6%(19), EngelⅢratio was 9.1%(8), and EngelⅣratio was 2.3%(2), and the difference was not statistically significant in the same grade of two groups (P > 0.05).Reservation rate and incidence rate of adverse reaction in levetiracetam combined with lamotrigine group were 90.8%(89) and 15.3%(15) respectively.While those in sodium valproate group were 80.7%(71) and 36.4%(32) respectively.The differences were statistically significant between the two groups (P < 0.05). ConclusionsLevetiracetam combined with lamotrigine treatment on postoperative patients with temporal lobe epilepsy may have better curative effects than sodium valproate treatment, and levetiracetam combined with lamotrigine has its advantage in reservation rate and less adverse reaction.
In this paper, the Fourier transform based minimum mean square error (FT-based MMSE) method is used to calculate the regional cerebral blood volume (rCBV) in magnetic resonance (MR) perfusion imaging, and the method is improved to handle the existing noise in the imaging process. In the experiments with signal-to-noise ratio (SNR) of 50 dB, the rCBV values were compared with the results using MMSE method. The effects of different SNRs on the estimation of rCBV were analyzed. The experimental results showed that MMSE was a simple way to filter the measurement noise, and could calculate rCBV accurately. Compared with other existing methods, the present method is not sensitive to environment, and furthermore, it is suitable to deal with the perfusion images acquired from the environment with larger SNR.
ObjectiveTo summarize the clinicopathological characteristics of 94 patients with pure mucinous breast carcinoma (PMBC), and to retrospectively analyze the prognosis and the prognostic factors. MethodsNinety four patients who were pathologically diagnosed with PMBC from November 1996 to October 2011 were retrieved from the database of breast cancer in West China Hospital. The clinicopathological and long term follow-up data of these patients were analyzed retrospectively. Results① Clinicopathological characteristics:These patients accounted for 1.48% (94/6 330) of all breast cancer patients who treated in our hospital during the same period. They were all female,with a median age of 45 years old (29-85 years)and median duration of 90 d (5-2920 d). A proportion of 63.83% (60/94) of these patients were premenopausal women. Ninety three patients had unilateral lesion, one patient had bilateral lesions, totally 95 lesions. A proportion of 85.29% (58/68) tumors were in T1-T2 staging, and 82.80% (77/93) tumors were node-negative. A proportion of 1.05% (1/95) tumors had metastasized at diagnosis. A proportion of 92.54% (62/67) tumors were in Ⅰ-Ⅱ staging, 84.34% (70/83) tumors were estrogen receptor (ER) positive, 74.70% (62/83) were progesterone receptor (PR) positive, and 20.25% (16/79) were human epidermal growth factor receptor 2 (HER-2/neu) positive. A proportion of 6.32% (6/95) of tumors had breast-conserving surgery. ② Preoperative diagnosis:The detection rate of malignance were 60.87% (14/23), 83.33% (40/48), and 100% (18/18), respectively for patients who were examined with mammography, ultrasonography, and mammography+ultrasonography, and there was significant difference between the three groups (P=0.006). ③ Prognosis and prognostic factors:The follow-up rate was 80.85% (76/94). Two cases had bone metastasis respectively in 14 and 26 months after operation, one of whom died. Both five-year and ten-year overall survival rate (OS) were 98.50%, both five-year and ten-year disease-free survival rate (DFS) were 95.80%. There was no lymph node involvement in patients of T1 phase, and no recurrence, metastasis or death occurred during the follow-up. The univariate analysis showed that the disease course, T staging, TNM staging, and HER-2/neu status were statistically significant prognostic factors for DFS situation (P<0.050). ConclusionsCases in this group displayed indolent behavior and favorable prognosis which are similar to western populations. The disease course, T staging, TNM staging, and HER-2/neu status appear to be significant predictors of worse prognosis. The combination of mammography and ultrasonography could largely improve the diagnostic accuracy, and breast-conserving therapy may be recommended for patients with no contraindications.
Objective To summarize the development of process and clinical practice for radiomics. Methods Relevant literatures about the development of process and clinical practice of radiomics were collected to make a review. Results Radiomics, which resulting from big data, had been used in diagnosis, assessment of prognosis, and predictionof therapy response for neoplasm. Conclusion Radiomics is an important part of precision medical imaging in the eraof big data.
ObjectiveTo discuss the value of CT in the diagnosis of ureteral tumor. MethodsWe retrospectively analyzed the CT features of 52 patients with ureteral tumor confirmed by operation, pathology and immunohistochemistry between August 2011 and July 2013. All patients underwent CT plain scan followed by enhanced scan, and 13 patients underwent CT Urography imaging. ResultsUreteral tumors occurred mainly in the lower ureter (20 cases), and 5 cases occurred in the upper ureter, 8 cases in the mid-upper ureter, 11 cases in the middle ureter, and 8 cases in the mid-lower segment. The lesions showed a lump or thickening of the wall, and the indirect signs included renal pelvis, ureter, bladder and ureter angle changes. ConclusionCT is valuable in the diagnosis of ureteral tumor. CT Urography can be very intuitive, multi-dimensionally displaying the wall and conditions outside the cavity, which has a great significance in guiding clinical operation.
ObjectiveTo investigate researches on pancreatic neoplasms and molecular imaging in recent five years and provide reference information for the majority of professionals in deep research. MethodsBibliographies from research literature of pancreatic neoplasms and molecular imaging in recent five years in PubMed database were downloaded. The publication years, journals, countries of publication, the first authors and the frequency of MJMEs were counted by Bicomb 2.0 software. The affiliations were analyzed artificially. MJMEs appeared no less than two times were intercepted as high frequency ones and the high frequency MJMEs co-occurrence matrix were formed. SPSS 22.0 statistical software were applied for clustering analysis with matrix, then to get the topic hotspots. ResultsA total of 28 literatures were screened out. The data of research trend, journals, research degree of countries were acquired. The number of high frequency MJMEs were 20 and among which 5 research hotspots were clustered. ConclusionsResearches on pancreatic neoplasms and molecular imaging are mainly in terms of therapy and genetics, diagnosis and metabolism, radionuclide imaging, pharmacology and pathology.
ObjectiveTo compare the predictive value of Balthazar computed tomography severity index (CTSI), Modified computed tomography severity index (MCTSI) and extrapancreatic inflammation on CT (EPIC) in patients diagnosed as acute pancreatitis with organ dysfunction based on the revised Atlanta classification. MethodsThe clinical data of patients diagnosed as acute pancreatitis from December 2013 to January 2014 were analyzed retrospectively. Four imaging score systems (CTSI, MCTSI, EPIC, and local complications) and two clinical score systems were assessed with ROC and AUC. Results①There were no statistical significances in the age, gender, time after onset of symptoms to CT scanning in 54 patients (P > 0.05).②CTSI, MCTSI, EPIC, and local complications were good independent predictors of organ dysfunction in the early phase (P < 0.05), while BISAP and NJSS were not (P > 0.05). ConclusionCT scoring systems can accurately evaluate organ dysfunction of acute pancreatitis in the early phase.
ObjectiveTo summarize the relevant studies of pharmacological mechanism of tamoxifen and its influence on ovary function in order to provide information and evidence for the therapy of breast cancer. MethodsPapers published from January 1950 to January 2014, were retrieved in MedLine, OVID, CBM, CNKI databases using the keywords on tamoxifen, drug metabolism, ovary, sex hormone, etc, 1286 papers were retrieved in English literatures, and 621 in Chinese literatures. Criteria of paper adoption:①The clinical and basic studies about metabolism of tamoxifen, metabolic effect of tamoxifen, and gene polymorphism of CYP2D6.②The role played by estrogen receptor and protein cofactors in tamoxifen effect.③The clinical and basic studies about tamoxifen induced ovulation, caused endometrial thickening, changed sex hormone levels. According to the above criteria, 152 papers were selected, and 77 papers out of them were finally analyzed and reviewed. Results①The tamoxifen metabolite 4-OH-N-tamoxifen was the main working component, the decreased levels could predict the poor prognosis.②The CYP2D6 gene polymorphism could affect the metabolic effect of tamoxifen and the therapeutic effect of patients with breast cancer.③The metabolic effect of tamoxifen needed the participation of the estrogen receptors and protein cofactors.④Tamoxifen could affect the reproductive system function through the estrogen receptor of H-P-O axis, ovary, and endometrium. ConclusionsMetabolic effect of tamoxifen is regulated by gene, it could affect reproductive system functions through estrogen receptor. the mechanism that tamoxifen cowld affect the hormone levels and wherther it could reflect the ovarian function by monitering the hormone levels continuously for patients with breast cancer need to be researched.
Objective To summarize the research progress of distributional heterogeneity of the molecular pathology characteristics in breast cancer. Methods The related literatures about the distribution of the molecular pathology characteristics in breast cancer were reviewed. Results The breast cancer had the same heterogeneity as other cancers. At the same time, the molecular pathology characteristics, such as estrogen receptor (ER), progesterone receptor (PR), Ki-67, and human epidermal growth factor receptor-2 (HER-2), had the distributional heterogeneity. The distributional heterogeneity of molecular pathology characteristics in breast cancer could effect the pathologic diagnosis, the treatment, and the prognosis. Conclusion Although there are some new techniques which were used to investigate the heterogeneity of breast cancer, but each way has some problems. The more attention should be paid to the research about the distributional heterogeneity of the molecular pathology characteristics in breast cancer.
ObjectiveTo investigate the feasibility of the extended nasolabial flap in repairing small or medium anterior buccal mucosal defects. MethodsBetween March 2013 and April 2014, 10 patients with anterior buccal mucosal defects were treated with extended nasolabial flaps. There were 8 males and 2 females with the average age of 47.2 years (range, 39-62 years). The left side was involved in 4 cases and the right side in 6 cases. The pathological types included 3 cases of oral leukoplakia (OLK), 3 cases of OLK with malignant changes, 1 case of malignant oral lichen planus, and 3 cases of papilloma. The clinical course ranged from 2 to 15 months (mean, 7.1 months). The resection was restricted to the mucosa and little buccinators without cheek penetration, and the defects ranged from 2.5 to 4.0 cm in width and 3.5 to 5.5 cm in length. The distance between defect and the corner of the mouth was 0.5 to 1.5 cm. A falcate flap was designed along the nasolabial fold with a pedicle lateral beside the corner of the mouth. The flap was lifted in the plane of the superficial muscular aponeurotic system from both terminal points to the region of the central pedicle. Then the flap was transposed intraorally through a transbuccal tunnel to cover the mucosal defect while the extra-oral incision was closed directly. ResultsAll flaps completely survived and all wounds healed primarily. All patients were followed up 6 to 18 months (mean, 10.4 months). All patients regained symmetrical appearances and normal mouth commissure only with linear scars hidden in the nasolabial folds. The mouth opening was 2.7 to 3.5 cm (mean, 3.1 cm) at last follow-up. The intraoral flaps healed perfectly with thin and flat outlooks. No cheek biting or fish-mouth deformity was observed. ConclusionThe extended nasolabial flap can be used to repair small or medium anterior buccal mucosal defects because it has the advantages of reliable blood supply, flexibility in design, simplicity in harvesting, and hidden donor site scars.