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This practice guideline focuses on the cognitive assessment for mild cognitive impairment in the Guangdong-Hong Kong-Macao Greater Bay Area. To achieve the standardization and normalization of its clinical practice and generate individualized intervention, the National Core Cognitive Center of the Second Affiliated Hospital of Guangzhou Medical University, the Cognitive Disorders Branch of Chinese Geriatic Society, the Dementia Group of Neurology Branch of Guangdong Medical Association and specialists from Hong Kong and Macao developed guidelines based on China's actual conditions and efficiency, economic cost and accuracy. The article addresses the significance, background, and the process of the assessment and follow-up to realize the promotion and dissemination of cognitive assessment.
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Objective To summarize the clinical and imaging characteristics of Rosai-Dorfman disease (RDD) in order to improve the diagnosis of the disease.Methods The clinical and imaging features of 10 patients with RDD proved by pathology were retrospectively analyzed and the related literatures were reviewed.Results Ten patients including 7 males and 3 females,aged 8 to 54 years old,with average of 32 years old.White blood cells (BCA) and erythrocyte sedimentation rate (ESR) in 8 cases were normal.Eight cases manifested as painless enlarged lymph node or mass,of which 4 cases were accompanied with multisystem involvement.Three lesions involved lymph nodes,5 lesions were located in extranodal sites,while 2 lesions involved both lymph node and extranodal sites.RDD occurred in lymph nodes (n=3) manifested as multiple enlarged lymph nodes on CT imaging,showing mild or moderate the enhancement,or a heterogeneous ring-enhancement.Of 5 extranodal RDD lesions,3 cases underwent MR exmination.2 lesions manifested as subcutaneous soft tissue mass on left shoulder and anterior abdominal wall,1 lesion manifested as intracranial mass accompany with localised cranial bone destruction.Lesions in all 3 cases had poor margins and showed scatted areas of high signal on diffusion weighted images.Lesions exhibited remarkable heterogeneous enhancement on Gd-DTPA enhanced MR imaging,dural/fascia tail sign and dilated blood vessels could be found around the lesions.Intrahepatic RDD lesion showed fast washing out phenomenon on CT enhanced imaging.In 2 cases involved both lymph node and extranodal sites,1 case manifested as swelling pharyngeal lymph chain and nasopharynx,enlargement of lymph nodes in bilateral submandibular and cervical region abdominal cavity on CT imaging,the enhancement is mild and moderate,accompany with osteolytic lesions in right proximal humerus on X-ray.For the other case,CT images manifested as bilateral neck lymphadenopathy,accompanied with soft tissue mass in nasal cavity,the lesion showed mild/moderate enhancement.Conclusions RDD mostly appears in young and middle-aged men,and is rarely preoperatively diagnosed.RDD mainly manifests as painless enlarged lymph node or mass.RDD has a broad spectrum of radiographic appearance,varied according to different location of lesion.Scatted higher signal areas on diffusion weighted images in the masses and significantly heterogeneity enhancement with dilated blood vessels around the lesion could be helpful in diagnosing of extranodal RDD.
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Objective To explore the clinical,CT and MRI features of ovarian adenofibroma(OAF)and improve the diagnostic level. Methods Ninety-two cases of OAFs were analyzed retrospectively and summarized the features including clinical manifestations ,CT and MRI images. Results The probability of unilateral ,serous and benign OAFs were 91.3%,89.1%and 97.8%. OAFs associated with uterine or/and ovarian lesions was 40.2%. The clinical manifestations of OAF was not typical. These OAFs were divided into 2 groups according to whether or not accompanied with uterus or/ and ovarian lesions. The clinical manifestations and laboratory indexes were only found abnormal menstruation rate(P<0.05),but there were no significant difference between other indexes. The performance of CT plain scan and CT/MRI enhanced scan had not characteristic.The percentage of the"black sponge"on T2WI image and hyperintensity on DWI image of OAFs were 40.0% and 65.0%. Conclusion The"black sponge"on T2WI image and hyperintensity on DWI image may be helpful to diagnose OAF.
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Objective To explore the clinical,CT and MRI features of ovarian adenofibroma(OAF)and improve the diagnostic level. Methods Ninety-two cases of OAFs were analyzed retrospectively and summarized the features including clinical manifestations ,CT and MRI images. Results The probability of unilateral ,serous and benign OAFs were 91.3%,89.1%and 97.8%. OAFs associated with uterine or/and ovarian lesions was 40.2%. The clinical manifestations of OAF was not typical. These OAFs were divided into 2 groups according to whether or not accompanied with uterus or/ and ovarian lesions. The clinical manifestations and laboratory indexes were only found abnormal menstruation rate(P<0.05),but there were no significant difference between other indexes. The performance of CT plain scan and CT/MRI enhanced scan had not characteristic.The percentage of the"black sponge"on T2WI image and hyperintensity on DWI image of OAFs were 40.0% and 65.0%. Conclusion The"black sponge"on T2WI image and hyperintensity on DWI image may be helpful to diagnose OAF.
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OBJECTIVE:To explore the effects of Cangfu daotan decoction on expression of organic anion transporting poly-peptide(oatp4a1)and level of sex hormone in the endometrium and ovary tissues of rats with obesity-type polycystic ovarian syn-drome(PCOS). METHODS:Obesity-type PCOS rat models were established. 50 rats were randomized into a normal control(iso-metric normal saline)group,a model(isometric normal saline)group,a metformin(0.043 g/kg)group and Cangfu daotan decoc-tion high-dose and low-dose [5.68 and 1.42 g(medicinal materials)/kg] groups. The rats were given drugs ig once a day for 14 con-secutive days. The expression of oatp4a1 protein in the endometrium and ovaries of the rats was determined by ECL and Western blot. The levels of luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T)and estradiol(E2)in rat’s se-rum were detected by ELISA. RESULTS:Compared to the normal control group,those in the model group had weaker expression of oatp4a1 protein in the endometrium and ovaries,higher levels of serum LH,LH/FSH and T,lower levels of serum FSH and E2. There were statistical significances(P<0.01). Compared to the model group,those in metformin group,Cangfu daotan decoction high-dose and low-dose group had higher expression of oatp4a1 protein in the endometrium and ovaries,lower levels of LH/FSH and T,higher levels of serum E2;those in metformin group and Cangfu daotan decoction high-dose group had lower levels of serum LH,higher levels of serum FSH. There were statistical significances(P<0.01 or P<0.05). CONCLUSIONS:Cangfu daotan decoc-tion can increase the expression of oatp4a1 in the endometrium and ovaries of obesity-type PCOS model rat,alleviate phlegmy dampness and regulate the level of sex hormone.
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To identify the species of Mycobacterium clinical isolates by molecular biology techniques,six clinical isolates which were preliminarily recognized as Mycobacterium tuberculosis by the TCH and PNB culture methods were selected in this study.PCR was applied to amplify the oxyR-ahpC interval resistant-zone(intergenic region) and the length of PCR product in four strains was the same as that of H37Rv,while the length in the other two strains was different from that of H37Rv but same as Mycobacterium intracellulare 95002.With sequencing and on-line homology comparison with H37Rv,U18263 and U71061,the DNA sequence of oxyR-ahpC intergenic region displayed a 99% homology with Mycobacterium intracellulare U71061 and an 84% homology with Mycobacterium tuberculosis H37Rv.In addition,the results of hsp65 PCR-restriction fragment length polymorphism analysis and multi-locus PCR amplification in the two strains were identical with those of Mycobacterium intracellulare 95002.These two clinical isolates which were preliminarily recognized as Mycobacterium tuberculosis by PNB and TCH culture methods were finally identified as Mycobacterium intracellulare.Results predicted that the application associated with various techniques of molecular biology would provide a faster,easier and more correct way for the species identification of Mycobacterium.
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Objective To evaluate prospectively the preoperative use of 16-multidetector computed tomography (MDCT) with cholangiography and angiography in determining the resectability of hilar cholangiocarcinoma.Methods From January 2002 to January 2009,75 consecutive patients with hilar cholangiocarcinoma underwent preoperative MDCT with cholangiography and angiography.3D images of the portal vein,hepatic artery,and bile ducts were created and viewed simultaneously.The accuracy of MDCT with cholangiography and angiography was determined by comparison with intraoperative and pathologic findings.Results All patients tolerated the CT imaging well.The sensitivity,specificity,and accuracy rates were 92.9%,100%,and 96%for portal invasion and 83.3%,100 %,and 93.3%for hepatic arterialinvasion.The accuracy rate of longitudinal tumor extension,using the Bismuth-Corlette classification system,was 96 %.The sensitivity,specificity,and accuracy of prediction of resectability were 95.7%,82.1%,and 90.7%,respectively.Conclusion Preoperative MDCT with cholangiography and angiography gave a good assessment of the degree of biliary and vascular involvement of hilar cholangiocarcinoma.It also accurately predicted resectability in patients with hilar cholangiocarcinoma.
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Objective To assess the value of MSCT and postprocessing techniques in displaying abnormal blood vessels of pulmonary sequestration. Methods Ten patients with pulmonary sequestration proved with operation and pathology underwent both plain and enhanced chest CT scan. The reconstructed images of maximum intensity projection, multiplanar reconstruction and volume rendering were analyzed retrospectively. Results Of 10 patients, intra-lobe type sequestration was seen in 9 patients and extra-lobar type in 1 patient. The lesions located in the left lower lobe in 8 patients and in the right lower lobe in 2 patients. Angiography postprocessing technique displayed abnormal supplying vessels in 9 patients (7 from descending aorta and 2 from abdominal aorta) and displayed the origin, courser, branches and distribution of lesions clearly. Vessels in 9 patients drained into inferior pulmonary veins except in one drained into azygos vein. Conclusion MSCT angiography with postprocessing reconstruction techniques can display abnormalities of pulmonary sequestration clearly and has great value in the diagnosis of pulmonary sequestration, so as might be the first choice in diagnosing pulmonary sequestration.
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Background and ObjectiveWHO Director-General declared that the 2019-nCoV outbreak constitutes a Public Health Emergency of International Concern,and the outbreak is still on-going.Chest CT had been a key component of the diagnostic workup for patients with suspected infection. In this retrospective study, we attempt to summarize and analyze the chest CT features of 2019-nCov infections, and to identify the typical features to improved the diagnostic accuracy of new coronavirus pneumonia (NCP). MethodsChest CT scans and Clinical data of 21 patients confirmed NCP in our hospital were enrolled.These patients were divided into mild and sever group according to clinical manifestations described by the 6th clinical practice guideline of NCP in China. Main clinical and chest CT features were analyzed and identify. ResultsFever (85.7%) and cough (80.9%) were the two main symptoms of NCP patients.More significantly higher incidence (85.7%) of shortness of breath in the severe cases. Multiple lesions in both lungs and with incidence of GGO(100%),vascular enlargement (76.5%) and cobblestone/reticular pattern(70.6%) were the major feature.The incidence of consolidation, mixed pattern and vascular enlargement features were up to 100% in the severe group, significantly higher than that of patients in mild group. In addition, the incidence of air-bronchogram, dilated bronchi with thickened wall and fibrosis in the severe group was significantly higher than that in the mild group. ConclusionsFever and cough are the typical clinical features of NCP patients, and chest CT mainly manifested as multiple lesions in both lungs, often accompanied by GGO, vascular enlargement and cobblestone/reticular pattern.Changes in these main CT features can indicate development of the disease Summary2019 novel Coronavirus (2019-nCov) had typical clinical manifestations (fever and cough), and presented with characteristic chest CT imaging features (multiple lesions in both lungs, often accompanied by GGO, vascular enlargement and cobblestone/reticular pattern), which are helpful to the radiologist in the early detection and diagnosis of this emerging global health emergency. In addition, changes in these main CT features can indicate development of the disease. HighlightsO_LIFever (85.7%) and cough (80.9%) were the two main symptoms of NCP patients.The incidence of shortness of breath was 85.7% in the severe cases, significantly higher than 21.4% in the mild cases. C_LIO_LIMultiple lesions in both lungs and with incidence of GGO (100%), vascular enlargement (76.5%) and cobblestone/reticular pattern (70.6%) were the major features of NCP patients. 85.7% of cases in serve group displayed 4-5 lobes were involved simultaneously. C_LIO_LIChanges in these main CT imaging features can indicate development of the disease. About 19.1% of patients (4 of 21) presented with a normal CT. C_LI