ObjectiveTo observe effect of interferon-γ in preventing intestinal adhesion following abdominal surgery in rats.MethodsA total of 60 Wistar rats were selected, which were randomly divided into a sham operation (SO) group, model group, dexamethasone (DXMS) group, and interferon-γ group, then the interferon-γ group was randomly divided into a low, medium, and high concentrations subgroups. Except for the SO group, the laparotomies with file friction caecum were performed for all the other groups to establish the intestinal adhesion model. SO group and model group were intraperitoneally injected with saline for 4 mL/kg. The 10 mg/kg dexamethasone was injected into the abdominal cavity of rats in the DXMS group. The 7.5×104, 1.5×105, and 3.0×105 U/kg interferon-γ concentrations were injected into the abdominal cavity of rats in the low, medium, and high concentrations subgroups respectively. The Nair grading of cecum adhesion degree was assessed on the 8th day after the surgery, then the histopathological change was observed by the HE staining under the microscopy and the hydroxyproline content in the cecum tissue was detected.Results① The intestinal adhesion: Compared with the SO group, the intestinal adhesions occurred in all the other groups and the degrees of intestinal adhesions evaluated by the Nair grading were more significantly serious (P<0.05), which in the DXMS group and the medium and high concentrations of interferon-γ subgroups were significantly reduced (P<0.05) as compared with the model group, which in the high concentration of interferon-γ subgroup was significantly reduced (P<0.05) as compared with the DXMS group. ② The microscopic observation of histopathological results: Compared with the DXMS group, the high concentration of interferon-γ could effectively reduce the occurrence of fibrous tissue and inflammatory cell infiltration, the intestinal wall muscular layer structure was complete, a few inflammatory cells scattered in the infiltration. ③ The hydroxyproline content: The contents of hydroxyproline in the cecum tissue of the model group, DXMS group, and interferon-γ subgroups were significantly increased (P<0.05) as compared with the SO group, which of the DXMS group and medium and high concentrations of interferon-γ subgroups were significantly decreased (P<0.05) as compared with the model group, which of the high concentration of interferon-γ subgroup was significantly decreased (P<0.05) as compared with the DXMS group.ConclusionInterferon-γ has a preventive and therapeutic effect on postoperative intestinal adhesion and cecum injuries.
The accurate position of the center of rotation (COR) is a key factor to ensure the quality of computed tomography (CT) reconstructed images. The classic cross-correlation matching algorithm can not satisfy the requirements of high-quality CT imaging when the projection angle is 0 and 180°, and thus needs to be improved and innovated. In this study, considering the symmetric characteristic of the 0° and flipped 180° projection data in sinogram, a novel COR correction algorithm based on the translation and match of the 0° and 180° projection data was proposed. The OTSU method was applied to reduce noise on the background, and the minimum offset of COR was quantified using the L1-norm, and then a precise COR was obtained for the image correction and reconstruction. The Sheep-Logan simulation model with random gradients and Gaussian noise and the real male SD rats samples which contained the heterogenous tooth image and the homogenous liver image, were adopted to verify the performance of the new algorithm and the cross-correlation matching algorithm. The results show that the proposed algorithm has better robustness and higher accuracy of the correction (when the sampled data is from 10% to 50% of the full projection data, the COR value can still be measured accurately using the proposed algorithm) with less computational burden compared with the cross-correlation matching algorithm, and it is able to significantly improve the quality of the reconstructed images.
ObjectiveTo investigate the clinical, radiological and pathological features of pulmonary lymphangitic carcinomatosis (PLC) from gastric signet ring cell carcinoma.MethodsThe data of 3 cases of PLC from gastric signet ring cell carcinoma were analyzed and relevant literature was reviewed. The electronic databases of Wanfang, VIP, CNKI and PubMed were searched by using the keywords " pulmonary lymphangitic carcinomatosis” and " gastric signet ring cell carcinoma”.ResultsThe average age of three patients was 34 years (ranging from 20 to 50 years). There were 2 males and 1 female. The three patients presented with non-specific respiratory complaints of cough and shortness of breath. Thickening of interlobular septa was the major radiographical abnormality. Mediastinal lymphadenopathy was seen in 1 patient. Bilateral pleural effusion was seen in 2 patients. However, gastroscopy revealed metastatic gastric signet ring cell carcinoma with the presence of lymphagitic carcinomatosis. One patient survived more than seven months with systemic chemotherapy began on day 7 of hospitalization based on the follow-up information available. Literature review found 2 cases of PLC from gastric signet ring cell carcinoma. Two cases were female aged 45 and 59 years. The chief complaints were dry cough and shortness of breath. The survival time was less than 1 month from diagnosis.ConclusionsPLC from gastric signet ring cell carcinoma is easily misdiagnosed as primary pulmonary diseases. Early identification, diagnosis and treatment are crucial to improve the survival of PLC patients.
Objective To evaluate the efficacy and safety of glucocorticoids (GC) monotherapy and GC combined with tacrolimus (TAC) therapy in patients with anti-synthetase syndrome-associated interstitial lung disease (ASS-ILD). Methods Through retrospective analysis and propensity score matching (PSM) analysis, the 2-year progression-free survival (PFS) and related side effects of ASS-ILD patients in TAC+GC group and GC monotherapy group were compared. Predictors associated with PFS were analyzed with COX. Results The 2-year PFS rate of TAC+GC group was better than that of GC group [P=0.0163; hazard ratio (HR) 0.347]; Univariate and multivariate analysis of the COX regression model for 2-year PFS in the two groups suggested that creatine kinase level (P=0.0019, HR 1.002) and initial treatment selection [(TAC+GC) vs. GC, P=0.0197, HR 0.207] were independent predictors of PFS; PSM analysis showed that the 2-year PFS rate of TAC+GC group (54.5%) was higher than that of GC group (18.2%) (P=0.0157, HR 0.275). In terms of adverse effect, there was no significant increase in GC+TAC group compared with GC group. Conclusion Compared with GC monotherapy, initial TAC+GC treatment significantly prolonged PFS in ASS-ILD patients and did not increase the incidence of drug-related complications.
ObjectiveThree cases of pulmonary tuberculosis misdiagnosed as pulmonary alveolar proteinosis were reported and analyzed in combination with literatures, so as to improve the ability of differential diagnosis of these two diseases. MethodsThe clinical data of 3 cases of pulmonary tuberculosis patients which were diagnosed by pathology whose imaging manifestations were similar to those of pulmonary alveolar proteinosis were collected and reviewed in combination with relevant literature. ResultsAll the 3 patients were male, with a chronic course , no typical clinical manifestations of pulmonary tuberculosis, CT imaging showed diffuse glass grinding shadow, thickened pulmonary lobular septa ,showed "Crazy-paving pattern". ALL the three patients were considered as " pulmonary alveolar proteinosis" initially, and finally confirmed by lung biopsy or acid-resistant bacilli found by bronchoalveolar lavage. Reviewing 8 literature reports with similar imaging findings, 1 case was misdiagnosed as pulmonary alveolar proteinosis, 3 cases were pulmonary alveolar proteinosis combined with pulmonary tuberculosis, and 4 cases were secondary pulmonary alveolar proteinosis. It was found that most patients had systemic or respiratory symptoms of pulmonary tuberculosis. CT images mainly showed diffuse ground glass shadows in bilateral lungs with thickening of lobular septa, and 3 patients also showed clustered small nodulars. Most patients improved after anti-tuberculosis treatment, with only one patient dying. ConclusionsThe imaging manifestations of atypical pulmonary tuberculosis are various, which are easy to be misdiagnosed when they are similar to " pulmonary alveolar proteinosis". Clinicians should raise their awareness of tuberculosis with this imaging characteristic.
ObjectiveTo investigate the diagnostic value and safety of electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound in peripheral pulmonary nodules.MethodsThe clinical imaging, surgical and pathological data of 60 patients with 76 peripheral pulmonary nodules who underwent electromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound guided biopsy in the Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from June 2020 to June 2021 were retrospectively analyzed. The diagnosis rate and complications were analyzed and summarized. The 76 pulmonary nodules were divided into a small pulmonary nodules group (10 nodules, diameter≤1 cm) and a pulmonary nodules group (1 cm<diameter≤3 cm, 66 nodules) according to diameter. The two groups were compared in terms of operation and diagnosis rate.ResultsPulmonary nodules diameter was 1.8±0.6 cm, operation time 29.8±8.6 min, navigation 2.9±0.9 times, biopsy 9.5±1.9 pieces. In the 76 pulmonary nodules, 55 were confirmed by pathology, with a total diagnosis rate of 72.4%, including 32 of malignant lesions and 23 of benign lesions. In the 76 pulmonary nodules, 59 had grade 0 hemorrhage, 17 had grade 1 hemorrhage, and none had grade 2 or more serious hemorrhage. Eight patients developed pneumothorax after surgery, and the degree of lung compression was less than 30%, which was improved after symptomatic treatment with oxygen inhalation. The operation time in the small pulmonary nodules group was significantly longer than that in the pulmonary nodules group, and there was no significant difference in diagnosis rate or complications between the two groups.ConclusionElectromagnetic navigation bronchoscopy combined with radial endobronchial ultrasound is a safe and effective method for the diagnosis of periphery pulmonary nodules, and it also has a high diagnostic rate for small pulmonary nodules (≤1 cm), which is worthy of clinical promotion and application.