The clinical effectiveness of reflectance optical spectroscopy for the in vivo diagnosis of oral lesions / 国际口腔科学杂志·英文版

Optical spectroscopy devices are being developed and tested for the screening and diagnosis of oral precancer and cancer lesions. This study reports a device that uses white light for detection of suspicious lesions and green-amber light at 545 nm that detect tissue vascularity on patients with several suspicious oral lesions. The clinical grading of vascularity was compared to the histological grading of the biopsied lesions using specific biomarkers. Such a device, in the hands of dentists and other health professionals, could greatly increase the number of oral cancerous lesions detected in early phase. The purpose of this study is to correlate the clinical grading of tissue vascularity in several oral suspicious lesions using the Identafi(®) system with the histological grading of the biopsied lesions using specific vascular markers. Twenty-one patients with various oral lesions were enrolled in the study. The lesions were visualized using Identafi(®) device with white light illumination, followed by visualization of tissue autofluorescence and tissue reflectance. Tissue biopsied was obtained from the all lesions and both histopathological and immunohistochemical studies using a vascular endothelial biomarker (CD34) were performed on these tissue samples. The clinical vascular grading using the green-amber light at 545 nm and the expression pattern and intensity of staining for CD34 in the different biopsies varied depending on lesions, grading ranged from 1 to 3. The increase in vascularity was observed in abnormal tissues when compared to normal mucosa, but this increase was not limited to carcinoma only as hyperkeratosis and other oral diseases, such as lichen planus, also showed increase in vascularity. Optical spectroscopy is a promising technology for the detection of oral mucosal abnormalities; however, further investigations with a larger population group is required to evaluate the usefulness of these devices in differentiating benign lesions from potentially malignant lesions.

Association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Anhui province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the association between mortality rate of hepatic carcinoma and the distance from Suihe River in Lingbi county, Suzhou, Anhui province.</p><p><b>METHODS</b>Using the disease mapping and spatial statistical analysis techniques,we described the spatial distributions of the mortality rate of hepatic carcinoma from 2005 to 2010 in Lingbi county. Taking the distance between villages and polluted rivers as proxy variable of environmental exposure, mortality rate of hepatic carcinoma in each village as dependant variable, and using the Glimmix model and Bayesian spatial model (BYM) to undertake the univariate and multivariate analysis, we investigatived the association between mortality rate of hepatic carcinoma and the water pollution of Suihe River in Lingbi county.</p><p><b>RESULTS</b>Obvious clustering of high mortality rate of hepatic carcinoma along the polluted river was observed in Lingbi county. Results of Glimmix model showed that whether spatial autocorrelation was considered or not, closer to the polluted river has higher mortality rate of hepatic carcinoma. Results of univariate analysis of the BYM model showed that, compared with the villages far from the polluted river more than 12 km (the mortality rate of hepatic carcinoma was 33.12/100 000(1068/3 224 562) ), the RR values of the hepatic carcinoma mortality was 1.38(95%CI:1.06-1.82) for the villages apart from the polluted river within 6 km (the mortality rate of hepatic carcinoma was 42.48/100 000(777/1 829 064)), and 1.13 (95%CI:0.92-1.39) for villages apart from the river between 6 and 12 km (the mortality rate of hepatic carcinoma was 35.65/100 000(651/1 825 848)). In the BYM model multivariate analysis, adding the volume of fertilizer and pesticides used per cultivated area, GDP per capita to do multivariate analysis were, the relation between mortality rate of hepatic carcinoma and distance from polluted rivers remains unchanged.</p><p><b>CONCLUSION</b>The mortality rate of hepatic carcinoma was associated with the exposure to the polluted river in Lingbi county. The polluted river may increase the hepatic carcinoma mortality of nearby residents.</p>

Analysis on the clustering of liver cancer mortality in Lingbi county, Anhui province, from 2005 to2010 / 中华流行病学杂志

Objective To observe the mortality and its changes on liver cancer in the past 30 years as well as to describe the spatial distribution of liver cancer deaths between 2005 and 2010 in Lingbi,Anhui province.Methods Using the mortality data from 1973-1975 and from 2005 to 2010 in Lingbi to compare with the relative national and historical data,to observe the trend of rapid increase on liver cancer mortality in Lingbi.Using the Poisson model,BYM model and hotspot detection method,standardized mortality ratio (SMR),relative risk(RR) value of liver cancer deaths of each village were calculated and the clustering of high liver cancer deaths was identified.Results Through an increase of 223.7％ on the SMR of liver cancer in the past 30 years,the standardized mortality of liver cancer in Lingbi had an increase of 74.1 percent than the national level in 2005-2010 but it was 22.7％ lower than the country level in 1973-1975.The SMR and RR values and their P values were higher in the villages which were located along the Kuisui River.Data from the clustering analysis showed that there had been significantly positive autocorrelation at the altitude of 5300 meters,and a very obvious hot spot of liver cancer deaths existing along the Kuisui River,especially at the bifurcation of the old Sui River and new Sui River was observed.Conclusion There was an alarming increase of liver cancer mortality in the past 30 years in Lingbi.The high mortality area mainly covered the villages along the Kuisui River,suggesting that there were common risk factors for hepatocellular carcinoma in the population at risk.

MR image-guided anterior direct arthrography of the shoulder / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the method of MR guided anterior direct arthrogaphy of shoulder and its clinical applications.</p><p><b>METHODS</b>From 2008.4 to 2008.10, 40 patients with rotator-cuff tear (29 males and 11 females, ranging in age from 22 to 70 years, with an average of 35 years) underwent MR guided anterior direct arthrogaphy of shoulder, so as to diagnosis shoulder wound. The results were compared to that of arthroscopy.</p><p><b>RESULTS</b>Shoulder arthrography showed lesons in 36 patients, and failure in 2 patients, including contrast media extravasation in 1 patient, and gas entry to joint cavity in 1 patient. Two patients showed no rotator cuff injuries. Twenty-eight patients were confirmed by arthroscopy as rotator-cuff injured in different degree. Twenty-six patients were confirmed injuries by both arthroscopy and MR guided anterior direct arthrogaphy.</p><p><b>CONCLUSION</b>MR guided anterior direct arthrogaphy of shoulder as a minimally invasive method in displaying the rotator-cuff tear has higher accuracy and wide clinical application prospect.</p>

Feasibility of whole body diffusion weighted imaging in detecting bone metastasis on 3.0T MR scanner / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the feasibility of whole body diffusion weighted imaging (DWI) in bone metastasis detection using bone scintigraphy as comparison.</p><p><b>METHODS</b>Forty-five patients with malignancy history were enrolled in our study. All the patients received the whole body DWI and bone scintigraphy scan within 1 week. The magnetic resonance (MR) examination was performed on 3.0T MR scanner using embedded body coil. The images were reviewed separately by two radiologists and two nuclear medicine physicians, who were blinded to the results of the other imaging modality. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the two techniques for detecting bone metastasis were analyzed.</p><p><b>RESULTS</b>A total of 181 metastatic lesions in 77 regions of 34 patients were detected by whole body DWI, and 167 metastatic lesions in 76 regions of 31 patients were identified by bone scintigraphy. The patient-based sensitivity and PPV of whole body DWI and bone scintigraphy were similar (89.5% vs. 81.6%, 97.1% vs. 91.2%), whereas, the patient-based specificity and NPV of whole body DWI were obviously higher than those of bone scintigraphy (85.7% vs. 57.1%, 60.0% vs. 36.4%). Ten regions negative in scintigraphy but positive in whole body DWI, mainly located in spine, pelvis, and femur; nine regions only detected by scintigraphy, mainly located in skull, sternum, clavicle, and scapula. The region-based sensitivity and specificity of whole body DWI were slightly higher than those of bone scintigraphy (89.5% vs. 88.4%, 95.6% vs. 87.6%).</p><p><b>CONCLUSION</b>Whole body DWI reveals excellent concordance with bone scintigraphy regarding detection of bone metastasis, and the two techniques are complementary for each other.</p>

Comparison of whole body MR diffusion weighted imaging and skeletal scintigraphy In detecting bone metastasis / 中华放射学杂志

0bjective To evaluate the application of whole body MR diffusion weighted imaging (DWI)in the detection of bone metastasis using skeletal scintigraphy as the referenee.Methods Fonv.two healthy volunteers and 38 patients with malignant tumors were enrolled in our studv.A11 the patients received MR examination and skeletal scintigraphy within one week.MR examination was performed on GE signa 3.0T MR scanner using a build.in body coil.The skeletal system Was divided into eight regons and the images of the whole body MR DWI and skeletal seintigraphy were reviewed to compare the two modalities patient by patient and region by region.The images were reviewed separately by two radiologists and two nuclear medicine physicians,who were blinded to the results of another imaging modality.Results A total of 169 metastatic lesions in 69 regions of 30 patients were detected by whole body MR DWI while 156 lesions in 68 regions of 29 patients were identified by skeletal seintigraphy.There were two cases negative in scintigraphy but positive in whole body MR DWI and one case positive in scintigraphy only.There were eight lesions negative in scintigraphy but positive in whole body MR DWI,mainly located in the spine.pelvis and femur.Seven 1esions were only detected by scintigraphy,mainly located in the skull.sternum.clavicle and scapula.Conclusion The whole body MR DWI reveals excellent consistency with skeletal scintigraphy regarding bone metastasis.and the two modalities are complementary for each Other.

Diffusion-weighted magnetic resonance imaging in diagnosis of Creutzfeldt-Jakob disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Creutzfeldt-Jakob disease (CJD), a rare disease, is uncharacterized by computed tomography (CT) and magnetic resonance imaging (MRI). This study was aimed to evaluate the diffusion-weighted MRI (DWI) manifestations of CJD and to discuss their diagnostic value.</p><p><b>METHODS</b>The findings of T(1)-weighted MRI (T(1)WI), T(2)-weighted MRI (T(2)WI), DWI and post-contrast MRI in 5 patients (3 patients with biopsy-proven CJD and 2 patients with clinically-proven CJD) were retrospectively analyzed in this study.</p><p><b>RESULTS</b>Four out of the 5 patients had cerebral atrophy of various degrees. One patient showed symmetric high signal intensity at the bilateral globus pallidus and the head of the caudate nucleus, with very high signal in the cerebral cortex on the DWI. This patient only had symmetric slightly high signal at the bilateral globus pallidus and putamen on T(2)WI. One patient had high signal intensity at the basal ganglia and cerebral cortex on DWI, but abnormal T(2) signal intensity at the bilateral paraventricular white matter on MRI. Two patients presented with widely gyri-like high signal intensity at the cortex on DWI, but routine MRI showed bilateral paraventricular long T(2) signal intensity in 1 patient and no abnormal findings in another. No abnormalities were shown by both routine MRI and DWI in the last patient.</p><p><b>CONCLUSIONS</b>DWI is more sensitive than its conventional counterpart in the depiction of CJD. DWI is more sensitive to detect cortical abnormal signal intensity in CJD not detected by T(2)WI.</p>

Bile cystadenocarcinoma:MRI findings with pathologic correlation / 中华放射学杂志

Objective To describe the MRI features and pathologic findings of biliary cystadenocarcinoma(BCAC)and to assess the diagnostic value of MRI in those tumors.Methods Five cases of BCAC were collected.All cases were proved by pathology.Non-enhanced and multiphase-enhanced MRI were performed in all cases.MRCP were performed in two cases.The MRI features of the five cases were reviewed retrospectively and correlated with pathologic findings.Results Histological evidence demonstrated five cases of BCAC.Four cases were solitary,whereas the other case was multifocal.All cases were solid and cystic lesions.Two cases were unilocular,whereas the other three cases were multilocular. Multiple mural nodules and irregular thickening cystic walls were presented in all cases.The cystic parts of the lesions were homogeneous in signal intensity and showed no enhancement after contrast administration in the five BCAC.Septa were present in three BCAC with multilocular cyst.On MRCP the bile duct dilatation was found in two BCAC.Conclusion MRI can reveal the characteristic findings of BCAC and accurate preoperative diagnosis can be made.

Reduction of postradiation xerostomia in patients with head and neck cancer by superior technology using 3D-RTPS / 实用口腔医学杂志

Objective: To observe the effect of superior technology using three dimension radiation treatment plans (3D-RTPS) in the reduction of postradiation xerostomia in patients with head and neck cancer. Methods: 3D-RTPS of conventional radiation and new superior technique were applied in the patients of 3 kinds of head and neck cancer (tumor in middle, lateral, between middle and lateral area of head and neck). Superior technology including superior ray entrance, multi fields, conformal irradiation and application of wedges. Analysis of 3D dose distributions and dose volume histograms (DVH) was used to evaluate the dose and volume in tumor, parotids and spinal cord in the patients. Tumor dose of 55.6～68.6 Gy (average 58.8 Gy) was given to the patients in conventional radiation group in 8 patients, 53.5～68.5 Gy (average 58.3 Gy) to new radiation technique group in 12 patients. Whole saliva flow rate and subjective xerostomia scores were assessed in patients during radiation course and follow-up. Results: The dose in contralateral parotids in patients with tumor in lateral area, between lateral and middle area in conventional radiation and new radiation technique groups were 51.8～64.3 Gy and 0.4～1.4 Gy, respectively. The dose in parotids in patients with tumor in middle area in conventional radiation and new radiation technique groups were 51.8 and 24.7 Gy respectively. The rate of xerostomia at the end of radiotherapy and in 4～6 months follow-up after radiotherapy in patients of new radiation technique group were 8.3 % (1/12) and 0 respectively. Those in patients in conventional radiation group were 87.5 % (7/8) and 50 % (4/8) respectively. Conclusion: Superior technology using 3D-RTPS can reduce the rate of postradiation xerostomia in patients with head and neck cancer.