Corona Virus International Public Health Emergencies: Implications for Radiology Management.

The outbreak of 2019 novel coronavirus (2019-nCoV) pneumonia was reported in Wuhan, Hubei Province, China in December 2019 and has spread internationally. This article discusses how radiology departments can most effectively respond to this public health emergency.

[Analysis of Screening Results in 501 Newborns with Hemolytic Disease].

OBJECTIVE: To explore the relationship between the serological detection of neonatal hemolytic disease (HDN) and related factors, and to observe the detection rate and specificity of the antibodies against the blood group in the newborn hemolytic disease. METHODS: Maternal-neonatal blood type was detected firstly, and then the direct antiglobulin test(DAT), the free antibody test and the antibody release test were used to detect the occurrence of HDN; For those suspected hemolytic disease except ABO or direct DAT result over 2+, the indirect antiglobulin test with irregular antibody were used for screening cells and the plasma of the patient and mother, and then to detezmine whether there is a corresponding antigen in the red blood cells of the patient to confirm whether hemolytic disease of the other blood type system exists or not. The analysis was carried out by SPSS 22 software. The statistical analysis of classified data was tested by χ2 test. P<0.05 was considered as statistically significance. RESULTS: A total of 501 cases of hyperbilirubinemia were collected. Among them 250 cases of HDN were diagnosed as HDN, and the detection rate was 49.90%.The detection rate of the male was 45.14%, and that of the female was 56.34%(χ2 =6.143, P<0.05). The average day-age of patients was 3.97±2.81 days. The analysis of relatianship between the detected rate of HDN and the day-age of HDN chilren showed that the day-age of HDN chilren affected the detected rate of HDN(χ2 =63.489, P<0.05). The analysis of positive rate of 3 test in HDN+ childen of every group found that the day-age had an infuence on the detected rate of direct antiglobulin test(χ2=18.976，P<0.01) and also had an influence on the detected rate of the free antibody test(χ2=9.650，P<0.05). The positive rate of the release test in HDN patients was highest（100%）. 244 cases suffered from ABO hemolysis, including 1 case of ABO hemolysis combined with Rh system (anti -E) hemolysis, 4 cases of Rh system (anti -D), 2 cases of MN system (1 case was caused by anti -M, 1 case was caused by low frequency anti -Mur). ABO HDN caused by anti-A or anti-B were not statisticaly significant. CONCLUSION: Hemolytic disease of the newborn is a common cause of neonatal hyperbilirubinemia. The positive rate of HDN has a certain relations with the sexual distinction and the day-age. But there is no significant difference between anti-A and anti-B type. At the same time, screening and identification of irregular antibodies should be carried out to avoid diagnostic errors caused by undetected antibody when necessary.

[Analysis of Success Rate and Influencing Factors for Collecting Peripheral Blood Hematopoietic Stem Cells by Combination of CTX or E-CHOP Chemotherapy with Mobilization of G-CSF in Patients with Multiple Myeloma].

OBJECTIVE: To analyze the success rate and influencing factors for collecting peripheral blood hematopoietic stem cells (HSC) by combination of cyclophosphamide (CTX) or E-CHOP chemotherapy combined with granulocyte colony stimulating factor (G-CSF) in patients with multiple myeloma. METHODS: The clinical data of 75 patients with multiple myeloma in our hospital were retrospectively analyzed. All patients received CTX or E-CHOP chemotherapy combined with G-CSF mobilization to collect HSC, and the success rate (CD34+ cell numbers was at least 2×106/kg) and its influencing factors were statistically analyzed. RESULTS: A total of 86 collections by mobilization were performed in 75 patients, with the average 3.22 (0.12-22.28)×106/kg of CD34+ cells, and the success rate of 74.42%. Single factor analysis revealed that the course number of chemotherapy and disease status before the collection significantly correlated with the success rate of HSC collection (P<0.05), and sex, age, disease type, ISS stage and mobilization method showed no significant correlation with the collection success rate (P>0.05). Multivariate Logistic regression analysis showed that the course number of chemotherapy positively related with the success rate of HSC collection (OR=2.95, 95% CI: 1.60-5.41, P<0.01), and there was no significant correlation with the disease status before collection (OR=1.01, 95% CI: 0.88-1.16, P=0.89). CONCLUSION: There are no significant effects of sex, disease type, ISS staging and mobilization methods on the success rate of HSC collection in patients with multiple myeloma, and the less course number of chemotherapy (<5) before collection show a higher success rate of HSC collection.

Pancreaticoduodenectomy assisted by 3-D visualization reconstruction and portal vein arterialization: A case report (a CARE-compliant article).

BACKGROUND: Three-dimensional visualization reconstruction, the 3-D visualization model reconstructed by software using 2-D CT images, has been widely applied in medicine; but it has rarely been applied in pancreaticoduodenectomy. Although the hepatic artery is very important for the liver, it has to be removed when tumor invades it. Therefore, portal vein arterialization has been used in clinic as a remedial measure, but there still is professional debate on portal vein arterialization. METHODS: Here, we report 1 case that was diagnosed with poorly differentiated adenocarcinoma of the duodenum. The tumor had large size and invaded surrounding organs and vessels. RESULTS: Preliminary diagnoses were poorly differentiated adenocarcinoma of the duodenum and viral hepatitis B. Pancreaticoduodenectomy assisted by 3-D visualization reconstruction and portal vein arterialization were performed in this case. The tumor was removed. Liver function returned to normal limits 1 week after operation. Digital subtraction arteriography showed compensatory artery branches within the liver 1 month after operation. CONCLUSION: 3-D visualization reconstruction can provide a reliable assistance for the accurate assessment and surgical design before pancreatoduodenectomy, and it is certainly worth adopting portal vein arterialization when retention of hepatic artery is impossible or conventional arterial anastomosis is required during pancreatoduodenectomy.

[Surgical treatment of abdominal aortic aneurysms in octogenarians].

OBJECTIVE: To evaluate the open surgery as well as the endovascular treatment of abdominal aortic aneurysms (AAA) in octogenarians. METHODS: Twenty AAA cases aging from 80 to 90 in the past six years were reviewed. Open surgery on 12 patients and endovascular repair on the other 8 ones were performed. RESULTS: During peri-operation, there were 2 mortality from the surgical group among all 20 cases. The endovascular group underwent significantly better operational procedure and complication situation than the surgical one. Eighteen cases were followed up for 3-69 months (average months) except for 2 patients of surgical group. Both group suffered 2 late mortality. The accumulated survival rate were 6/10 in the surgical group and 6/8 in the endovascular group, respectively. CONCLUSION: Surgical treatment in applicable for octogenarians with AAA. The endovascular repair was preferable to suitable cases.

Pancreatoduodenectomy with vascular reconstruction in treating carcinoma of the pancreatic head.

BACKGROUND: The incidence of carcinoma of the pancreas is increasing in the world. Pancreatic carcinoma is characterized by early local extension to contiguous structures and metastases to regional lymph nodes and the liver. This study was conducted to increase the rate of pancreatoduodenectomy combined with vascular reconstruction. METHODS: Pancreatoduodenectomy with vascular reconstruction was performed for 79 patients at a number of hospitals in Fujian Province, Zhejiang Province, Shanghai and Xinjiang Uyghur Autonomous Region from April 1994 to December 2003. One of these patients also underwent right hemicolectomy; but all received through superior mesenteric vein (SMV)-portal vein (PV) reconstruction. The reconstructions of the superior mesenteric artery (SMA) and hepatic artery (HA) were performed in 4 patients, and reconstructions of the SMA or HA were carried out in 7 and 4 patients respectively. Partial reconstruction of the inferior vena cava (ICV) was done in 2 patients when the tumor was adhering to the wall of the inferior caval vein. RESULTS: Four patients died during the peri-operative period, with a mortality rate of 5%. No complications such as biliary or pancreatic fistulae or artificial blood vessel infection were noted. Histological examination showed one patient with neuroendocrine cancer and the other 78 patients with adenocarcinoma of the pancreatic head. Resected endothelia and vascular margins proved to be microscopically tumor-free. Follow-up for 3 months to 10 years for all except two patients showed 7 of the 9 patients who had undergone resection and reconstruction of the SMA and HA died 7 months or 4 years after operation and 37 survived for over 3 years and 12 for more than 5 years. The rest are still under follow-up. CONCLUSION: Pancreatoduodenectomy with vascular reconstruction for carefully selected patients with carcinoma of the pancreatic head has proved to be a safe and reliable treatment, capable of raising the rates of tumor resection and survival.

[Clinical analysis of primary squamous cell carcinoma of the breast].

OBJECTIVE: To study the clinicopathological features of primary squamous cell carcinoma (SCC) of breast and the diagnosis and treatment of the disease. METHODS: The clinical, operative and pathological data from 7 cases of SCC of breast were retrospectively analysed. RESULTS: Five patients complained of painless mass and two of them were accompanied with local pain. All patients were diagnosed as having SCC by fine-needle aspiration before operation. Two patients underwent modified radical mastectomy, and the others received radical mastectomy. Pathological examination showed primary squamous cell carcinoma of the breast with metastasis to axlliary lymph nodes in one patient. Follow-up of four patients revealed that two patients are living well and two patients died. Three patients lost to follow up. CONCLUSION: The diagnosis of primary squamous cell carcinoma of the breast is dependent on pathological results. Radical mastectomy including modified radical mastectomy is most effective in the treatment of mammary SCC. Postoperative chemotherapy and radiation are necessary auxiliary therapy.