目的探讨低张结肠充气16层螺旋CT扫描方法对结肠癌术前诊断及分期的价值。方法将47例临床术前病理证实的结肠癌患者采用低张充气灌肠后用16层螺旋CT进行容积扫描,对原始容积数据进行拆薄重建,卷集核采用B10s very smooth,层厚2mm,层间距...目的探讨低张结肠充气16层螺旋CT扫描方法对结肠癌术前诊断及分期的价值。方法将47例临床术前病理证实的结肠癌患者采用低张充气灌肠后用16层螺旋CT进行容积扫描,对原始容积数据进行拆薄重建,卷集核采用B10s very smooth,层厚2mm,层间距1-1.5mm,进行层厚5mm,层间距5mm的横断、冠状、矢状面的重建。以手术病理为标准,统计16层螺旋CT对结肠癌检出的敏感性和准确性,进行16层螺旋CT影像T分期和手术病理T分期对照分析。结果47例患者顺利完成低张结肠充气16层螺旋CT平扫和增强扫描,检查出所有结肠肿瘤病变,敏感性是100%,准确性100%。16层螺旋CT对47例结肠癌的分期分别是:T1期5例,占10.64%(5/47);T2期10例,占21.28%(10/47);T3期14例,占29.79%(14/47);T4期18例,占38.30%(18/47)。与手术病理T分期对比的结果分别是:T1期、T2期达100%;T3期92.86%;T4期94.74%。结论低张结肠充气16层螺旋CT检查是结肠癌术前检查的好方法之一,它能对结肠癌提供更准确的诊断及术前分期的信息,是结肠癌术前诊断和判断肿瘤的侵犯程度非常实用的检查方法之一,可以作为结肠癌术前的常规检查。展开更多
Background: Primary pulmonary angiosarcoma is extremely rare and the prognosis is very poor. We report a combination therapy of pneumonectomy and intrapleural hypotonic hyperthermic chemotherapy (IPHHC). Case report: ...Background: Primary pulmonary angiosarcoma is extremely rare and the prognosis is very poor. We report a combination therapy of pneumonectomy and intrapleural hypotonic hyperthermic chemotherapy (IPHHC). Case report: A 48-year-old male with exertional dyspnea was found to have a left massive pleural effusion. Bronchoscopic examination displayed endobronchial stenosis of the left lower bronchus B8,9,10?and diagnosed with pulmonary angiosarcoma. Chest computed-tomographic scanning revealed a 5-cm mass in the left inferior lobe, which invaded the left upperbronchus. Intrapleural dissemination and malignant pleural effusion were also suspected (cT3N1M1a,?c-stage IV). As a palliative initial therapy, we performed a pneumonectomy. On the 7th?postoperative day, under general anesthesia, we performed video-assisted IPHHC (43°C, 60 min, 200 mg/m2?of CDDP). After the IPHHC, there was no major adverse event (more than Grade 3) during the postoperative course. Histological examination of the resected specimen revealed a highly-cellular growth of atypical spindle cells with a storiform pattern. By immunohistochemical testing, the tumor cells stained positive for markers including CD31 and the factor VIII related antigen, and the diagnosis of pulmonary angiosarcoma was made. No adjuvant chemoradiotherapy was given, and the postoperative clinical course was uneventful. Although there had been a recurrence in the chest wall, the patient eventually died twenty-one months later. Conclusion: As a new therapeutic option, we performed IPHHC after the pneumonectomy for an advanced pulmonary angiosarcoma with malignant pleural effusion. Although the patient had a recurrence in the chest wall, he had a reasonable postoperative outcome, that is, he returned to a work, retained a good quality of life and had a longer survival in spite of the poor prognosis of the pulmonary angiosarcoma.展开更多
BACKGROUND： Aquaporin-4 （AQP4） is abundant in astrocytes, ependymal cells, and the choroid plexus, and is associated with cerebrospinal fluid formation and osmoregulation. AQP4 is speculated to be the hypothalamic ...BACKGROUND： Aquaporin-4 （AQP4） is abundant in astrocytes, ependymal cells, and the choroid plexus, and is associated with cerebrospinal fluid formation and osmoregulation. AQP4 is speculated to be the hypothalamic osmoreceptor and regulator of water balance. OBJECTIVE： To examine AQP4 expression and its role in cultured rat astrocytes after exposure to hypotonic medium. DESIGN, TIME AND SETTING： Randomized control experiment. This experiment was carried out in the Research Room of Neurobiology, Chongqing University of Medical Science, China, between April and October 2003. MATERIALS： Two-day-old newborn Wistar rats （n =20）, weighing 10- 15 g, were purchased from the Experimental Animal Center of Chongqing University of Medical Science, China. METHODS： Purified rat cerebral cortical astrocytes were isolated fiom Wistar rats for in vitro cell culture experiments. The cells were randomly divided into control and hypotonic groups. The in vitro cell edema model was established by exposing astrocytes to hypotonic medium （268, 254, or 240 mmol/L）. Cells in the control group were cultured in normal culture medium. MAIN OUTCOME MEASURES： Morphological changes in astrocytes were observed under an inverted microscope and a transmission electron microscope after cells were cultured for 3, 6, 12, or 24 hours with hypotonic medium or normal culture medium. In each group, AQP4 protein and mRNA expression were assessed by immunocytochemistry, in situ hybridization, and reverse transcription polymerase chain reaction at the different time points. RESULTS： After astrocytes were cultured for 3, 6, 12, or 24 hours with hypotonic medium （268, 254, 240 mmol/L）, they showed typical features of cell edema. In the control group, no astrocytes developed pathological changes. There were no significant changes in the AQP4 mRNA and protein expression in the control group at any of the time points alter astrocytes were cultured with normal culture medium （P 〉 0.05）. Compared with the control group, AQP4 mRN展开更多
文摘目的探讨低张结肠充气16层螺旋CT扫描方法对结肠癌术前诊断及分期的价值。方法将47例临床术前病理证实的结肠癌患者采用低张充气灌肠后用16层螺旋CT进行容积扫描,对原始容积数据进行拆薄重建,卷集核采用B10s very smooth,层厚2mm,层间距1-1.5mm,进行层厚5mm,层间距5mm的横断、冠状、矢状面的重建。以手术病理为标准,统计16层螺旋CT对结肠癌检出的敏感性和准确性,进行16层螺旋CT影像T分期和手术病理T分期对照分析。结果47例患者顺利完成低张结肠充气16层螺旋CT平扫和增强扫描,检查出所有结肠肿瘤病变,敏感性是100%,准确性100%。16层螺旋CT对47例结肠癌的分期分别是:T1期5例,占10.64%(5/47);T2期10例,占21.28%(10/47);T3期14例,占29.79%(14/47);T4期18例,占38.30%(18/47)。与手术病理T分期对比的结果分别是:T1期、T2期达100%;T3期92.86%;T4期94.74%。结论低张结肠充气16层螺旋CT检查是结肠癌术前检查的好方法之一,它能对结肠癌提供更准确的诊断及术前分期的信息,是结肠癌术前诊断和判断肿瘤的侵犯程度非常实用的检查方法之一,可以作为结肠癌术前的常规检查。
文摘Background: Primary pulmonary angiosarcoma is extremely rare and the prognosis is very poor. We report a combination therapy of pneumonectomy and intrapleural hypotonic hyperthermic chemotherapy (IPHHC). Case report: A 48-year-old male with exertional dyspnea was found to have a left massive pleural effusion. Bronchoscopic examination displayed endobronchial stenosis of the left lower bronchus B8,9,10?and diagnosed with pulmonary angiosarcoma. Chest computed-tomographic scanning revealed a 5-cm mass in the left inferior lobe, which invaded the left upperbronchus. Intrapleural dissemination and malignant pleural effusion were also suspected (cT3N1M1a,?c-stage IV). As a palliative initial therapy, we performed a pneumonectomy. On the 7th?postoperative day, under general anesthesia, we performed video-assisted IPHHC (43°C, 60 min, 200 mg/m2?of CDDP). After the IPHHC, there was no major adverse event (more than Grade 3) during the postoperative course. Histological examination of the resected specimen revealed a highly-cellular growth of atypical spindle cells with a storiform pattern. By immunohistochemical testing, the tumor cells stained positive for markers including CD31 and the factor VIII related antigen, and the diagnosis of pulmonary angiosarcoma was made. No adjuvant chemoradiotherapy was given, and the postoperative clinical course was uneventful. Although there had been a recurrence in the chest wall, the patient eventually died twenty-one months later. Conclusion: As a new therapeutic option, we performed IPHHC after the pneumonectomy for an advanced pulmonary angiosarcoma with malignant pleural effusion. Although the patient had a recurrence in the chest wall, he had a reasonable postoperative outcome, that is, he returned to a work, retained a good quality of life and had a longer survival in spite of the poor prognosis of the pulmonary angiosarcoma.
基金the National Natural Science Foundation of China, No.30070247
文摘BACKGROUND： Aquaporin-4 （AQP4） is abundant in astrocytes, ependymal cells, and the choroid plexus, and is associated with cerebrospinal fluid formation and osmoregulation. AQP4 is speculated to be the hypothalamic osmoreceptor and regulator of water balance. OBJECTIVE： To examine AQP4 expression and its role in cultured rat astrocytes after exposure to hypotonic medium. DESIGN, TIME AND SETTING： Randomized control experiment. This experiment was carried out in the Research Room of Neurobiology, Chongqing University of Medical Science, China, between April and October 2003. MATERIALS： Two-day-old newborn Wistar rats （n =20）, weighing 10- 15 g, were purchased from the Experimental Animal Center of Chongqing University of Medical Science, China. METHODS： Purified rat cerebral cortical astrocytes were isolated fiom Wistar rats for in vitro cell culture experiments. The cells were randomly divided into control and hypotonic groups. The in vitro cell edema model was established by exposing astrocytes to hypotonic medium （268, 254, or 240 mmol/L）. Cells in the control group were cultured in normal culture medium. MAIN OUTCOME MEASURES： Morphological changes in astrocytes were observed under an inverted microscope and a transmission electron microscope after cells were cultured for 3, 6, 12, or 24 hours with hypotonic medium or normal culture medium. In each group, AQP4 protein and mRNA expression were assessed by immunocytochemistry, in situ hybridization, and reverse transcription polymerase chain reaction at the different time points. RESULTS： After astrocytes were cultured for 3, 6, 12, or 24 hours with hypotonic medium （268, 254, 240 mmol/L）, they showed typical features of cell edema. In the control group, no astrocytes developed pathological changes. There were no significant changes in the AQP4 mRNA and protein expression in the control group at any of the time points alter astrocytes were cultured with normal culture medium （P 〉 0.05）. Compared with the control group, AQP4 mRN
