[Rare tumor of internal auditory canal].

Objective: To explore the clinical features and treatment strategy of rare tumor in the internal auditory canal(IAC). Methods: A retrospective study was carried out in 213 patients with lesion of ICA form January 2010 to December 2020. According to imaging features, surgical findings, and pathological diagnosis, there were 7 cases of non-sporadic acoustic neuroma, including 2 cases of cavernous hemangioma, 2 cases of aneurysm, 1 case of intralabyrinthical schwannoma, 1 case of meningioma, and 1 case of unilateral neurofibromatosis type 2 (NF2). The clinical manifestations, imaging data and intraoperative conditions as well as the formulation of individualized treatment strategies and prognosis were comprehensively analyzed. Results: In addition to hearing loss, cavernous hemangioma early appeared damage of facial nerve. CT showed expansion and calcification of IAC. Patients with aneurysm appeared tinnitus and vertigo early. CT showed enlargement of ampulla shape of IAC. DSA or MRA can help confirm the diagnosis. Patients with intralabyrinthine schwannoma early appeared refractory vertigo. High resolution MRI was helpful for diagnosis. "Dural tail sign" can be seen on enhanced MRI of meningeoma. Neurofibromatosis type 2 usually presented as bilateral vestibular schwannomas,but a few patients presented only with unilateral vestibular schwannomas.. All patients underwent labyrinth approach resection except one patient with NF2 for followed-up. Their postoperative symptoms were relieved. No tumor recurrence was observed during 6-3 years of follow-up. Conclusions: The clinical and imaging manifestations of rare tumors of the internal auditory canal are different. The principle of treatment is also different. It is helpful to avoid the serious consequences caused by blind operation to confirm diagnosis before operation.

[Pre-clinical in vivo evaluation study on a new Chinese-made surgical biopatch for atrial septum].

Objective: To evaluate the safety and effectiveness of a new Chinese-made surgical biopatch for atrial septum under the establishment of atrial septal defect animal model in miniature pigs. Methods: From June 2018 to April 2019, 26 pigs were divided into experimental group (15 pigs) and the control group (11 pigs). Animal models of atrial septal defect were established by traditional surgical methods. The to-be-evaluated and listed surgical biological patches (with a diameter of 10 mm) were implanted in the experimental group and the control group to repair the atrial septal defect. Cardiac ultrasound and blood examination of all animals were performed before and at 7, 30, 90, 180 days after operation, the results were analyzed with repetitive measurement and analysis of variance. At 90 days and 180 days after the operation, tissue samples were taken from animals after euthanasia. Pathological examination of heart and major organs were conducted. The independent sample t test and rank sum test were used to compare the data between the two groups, and the nonparametric was used to compare the patch calcification score between the two groups. Results: In total of 26 animals, 14 animals in the experimental group(6 at 90 days, 8 at 180 days) and 9 animals in the control group(4 at 90 days, 5 at 180 days) reached the end of the experiment. The other 3 animals (1 in the experimental group and 2 in the control group) died of arrhythmia, whole heart failure and right heart failure, the results of pathological examination showed that the causes of death were unrelated to the experimental materials. Cardiac ultrasound showed no patch leakage in all animals. There was no statistically significant difference in cardiac ultrasound and blood examination between the two groups at different time points after operation (all P>0.05). The pathological results showed that all the implants were intact and had good biocompatibility. There was no significant difference in the mean endothelialization rate between the experimental group and the control group at 90 and 180 days after operation ((80.8±29.1)% vs. (82.5±23.6)%, t=0.095, P=0.927; (78.8±36.4)% vs. (82.0±19.2)%, t=0.182, P=0.859) on 90 and 180 days, there was no significant difference in the patch calcification score between the two groups (1.00(1.25) vs. 2.00(0.75), Z=6.500, P=0.214; 0(0.75) vs. 1.00(2.00), Z=12.000, P=0.139). Conclusion: The new Chinese-made surgical biopatch for atrial septum has comparable safety and efficacy to that of the marketable patch in miniature pig atrial septal defect animal model.

[Diagnosis value of late gadolinium enhancement derived from magnetic resonance imaging in patients with acute myocardial infarction].

Objective: To explore the diagnosis value of late gadolinium enhancement(LGE) detected by magnetic resonance imaging(MRI) in acute myocardial infarction(AMI) patients. Methods: The clinical and MRI data of 52 AMI patients hospitalized from January 2016 to July 2017 in our hospital were retrospectively analyzed. All patients received medication and revascularization therapies after admission and cardiac magnetic resonance examination was performed within 1 week after admission. According to whether there was LGE, AMI patients were divided into LGE(+) group(33 cases) and LGE(-) group(19 cases). According to the existence of microvascular obstruction(MVO) and/or intramyocardial hemorrhage(IMH),LGE(+) patients were divided into MVO/IMH(+) group(18 cases) and MVO/IMH(-) group(15 cases). Results: (1)There were no statistical significance between the LGE(+)group and LGE(-)group in the age, gender,smoking history, hypertension, diabetes mellitus, dyslipidemia, ventricular arrhythmia, culprit vessel, left ventricular end-diastolic volume(LVEDV), and left ventricular end-systolic volume(LVESV) (all P>0.05). The left ventricular ejection fraction was significantly lower in LGE(+) group than in LGE(-) group( (38.7±17.6) % vs. (51.2±7.9)%, P=0.001). (2)The infarct size was positively correlated with LVEDV and LVESV(r=0.436,P=0.011;r=0.479,P=0.005,respectively), and negatively correlated with left ventricular ejection fraction (r=-0.641, P<0.001) in LGE(+) group. (3) The infarct size, LVEDV, and LVESV were significantly higher in MVO/IMH(+) group thanin MVO/IMH(-) group ((26.5±7.3)%vs. (16.2±8.3)%, P=0.001; (145.7±40.9)ml vs. (112.2±23.8)ml,P=0.009; (90.0±30.8)ml vs. (61.4±19.0)ml,P=0.004, respectively), and the left ventricular ejection fraction was significantly lower in MVO/IMH(+) group than in MVO/IMH(-) group ((29.8±15.0)% vs. (49.3±14.5)%, P=0.001). Conclusions: LGE detected bycardiac magnetic resonance can provide useful information on the myocardial necrosis extent of AMI patients. Presence of MVO/IMH in LGE(+) patients is linked with larger infarct size and worse cardiac dysfunction in AMI patients.

[Analysis of the correlation between deep medullary veins and clinical prognosis of middle cerebral artery stroke].

Objective: To investigate the relativity between the distribution of deep medullary vein (DMV) in patients with middle cerebral artery stroke and clinical prognosis by using susceptibility-weighted imaging (SWI). Methods: A total of 144 cases of middle cerebral artery stroke patients and 55 healthy volunteers were retrospectively analyzed from January 2015 to October 2015 in order to investigate the symmetrical characteristic and the classification of DMV, then 30 cases were followed up. Kappa test was used to consider the consistency of judging DMV symmetry and type data by two radiologists. Results:Kappa value in DMV symmetry and DMV type were 0.875 and 0.852. Chi-square test analysis revealed a statistically significant difference of DMV symmetry between healthy control and stroke group(χ(2)=31.046, P=0.000). There was correlation between DMV type and NIHSS score in stroke group (r(s)=0.208, P=0.025). There was no statistically significant difference of DMV distribution in the different periods of stroke group (P=0.110). But there was statistically significant difference of DMV distribution between acute and chronic stroke (P=0.018). Among 30 follow-up cases, 18 cases with asymmetry DMV changed into symmetry after stroke therapy. In 8 cases with symmetry DMV, the diameter of DMV became smaller after treatment. In 4 cases, DMV had no changes. Conclusions: DMV in patients of MCA stroke are mostly asymmetry distribution. DMV classification can be used as an imaging standard to predict the prognosis of stroke patients.

[Preliminary study on assessment of lexiscan-induced blood-brain barrier opening and its level by CT perfusion imaging].

Objective: To evaluate the level of lexiscan-induced blood-brain barrier opening of healthy rabbits via CT perfusion weighted imaging (PWI) scan. Methods: Between November 2014 and May 2015, thirty New Zealand white rabbits were randomly assigned into three groups: the experimental group A1 which received one injection of lexiscan(1 ml/kg); the experimental group A2 which received three times injection of lexiscan(total dose: 1.5 ml/kg), finished within 15 minutes; the control group B which was injected the same volume normal saline(1 ml/kg), after 30 minutes, CT PWI scan was performed. Then cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and permeability surface(PS) of the region of interest of each group were acquired and compared statistically. Five cases of each group were injected with 2% Evans blue intravenously posterior to imaging. After one hour of infusion, all the animals were killed. Their brains were examined for the determination of Evans blue distribution. Results: Both the values of CBF and CBV and the staining with Evans blue of the group A1(CBF: (89.88±2.21), (81.42±4.28) ml·(100 g)-1·min-1; CBV: (3.97±0.43), (3.66±0.16) ml/g)and group A2 (CBF: (75.16±0.84), (63.66±7.21) ml·(100 g)-1·min-1; CBV: (4.07±0.01), (3.75±0.05) ml/g) were higher than those of the group B(CBF: (20.08±5.08), (14.58±8.62) ml·(100 g)-1·min-1; CBV: (0.85±0.04), (0.65±0.17) ml/g), the differences were all statistically significant (all P<0.01). While there was no statistically difference between group A1 and group A2(P>0.05). The value of PS of the group A2((22.43±8.09), (20.20±7.01)ml·(100 g)-1·min-1 )was higher than that of group A1((13.82±4.44), (10.12±2.44)ml·(100 g)-1·min-1) and group B(0.00, 0.00)(the lowest one), the differences were all statistically significant(all P<0.01). The value of MTT of the group A1((2.50±0.82, 2.47±0.10) s) had no statistical difference with group A2 and group B, while the value of group A2((4.50±0.17), (4.72±0.15) s) was higher than that of group B((1.88±0.09), (1.99±0.00) s), the differences were all statistically significant (P<0.05). Conclusion: Changes in hemodynamics of lexiscan-induced blood-brain barrier opening can be monitored by CT PWI scan. When the total dose of lexiscan increasing, the level of the BBB opening is higher with significantly increased CBF, CBV, PS and MTT.

Comparable efficacy of self-monitoring of quantitative urine glucose with self-monitoring of blood glucose on glycaemic control in non-insulin-treated type 2 diabetes.

AIM: To assess whether self-monitoring of quantitative urine glucose or blood glucose is effective, convenient and safe for glycaemic control in non-insulin treated type 2 diabetes. METHODS: Adults with non-insulin treated type 2 diabetes were recruited and randomized into three groups: Group A, self-monitoring with a quantitative urine glucose meter (n = 38); Group B, self monitoring with a blood glucose meter (n=35); Group C, the control group without self monitoring (n=35). All patients were followed up for six months, during which identical diabetes care was provided. RESULTS: There was a significant decrease in HbA1c within each group (p < 0.05). At the study conclusion, mean changes in HbA1c from baseline were -1.9% for Group A, -1.5% for Group B and -1.0% for Group C, and the proportion of patients achieving HbA1c ≤ 6.5% were 38.9%, 35.3% and 20.0% respectively. However, no significant differences between the groups were found. The average monitoring frequency was significantly higher in Group A than in Group B. The incidence of hypoglycaemia and quality of life scores were similar between the groups. CONCLUSIONS: This study suggests that self-monitoring of urine glucose has comparable efficacy on glycaemic control, and facilitates better compliance than blood self monitoring, without influencing the quality of life or risk of hypoglycaemia.

High dose mitomycin C for treatment of advanced gastric cancer.

Thirty five patients (26 males and 9 females) with advanced gastric cancer confirmed by pathology were treated by high-dose mitomycin C. According to the following dose and schedules: Mitomycin C 20 mg intravenously per week and a total of 60 mg. Three weeks later, all the patients received FT-207 600 mg daily and a total of 20-40 g. The ages ranged from 24 to 75 years, 11 had cancer of cardia, 6 had cancer of gastric body, and 18 had cancer of gastric antrum. Eleven patients could not have an operation. Seventeen patients were recurrence of post operation. Eighteen of 35 patients received CR (7/35) and PR (11/35), the response rate was 51.43% of the responders, the median duration of remission and survival were 7.3 (range, 2-16) and 12.2 (range, 3-30) months, respectively. Common doses were instilled. The main side effects were leukopenia (10/35) and thrombocytopenia (7/35). None of these patients had liver and kidney function damage.

Combined treatment with photodynamic therapy and chemotherapy for advanced cardiac cancers.

In all, 144 patients with advanced cardiac cancers have been treated by photodynamic therapy (PDT), combined chemotherapy and chemotherapy alone from September 1982 to July 1990. A total of 5 mg kg-1 haematoporphyrin derivative (HpD) was intravenously given 48-72 h prior to PDT. The light source was an argon dye laser with an output beam of 630 nm. The irradiation time varied between 12 and 25 min with a fluence of 100-350 mW cm-2. The entire tumour was irradiated with a light dose of 100-250 J cm-2. The combination of UFT and mitomycin C was used as standard chemotherapy. There were 26 responders out of 55 patients (47.3%) in the group treated with PDT alone, 24 out of 41 (58.5%) in the PDT+chemotherapy group, and 24 out of 48 (50.0%) in the chemotherapy alone group. In the PDT+chemotherapy group 19.5% patients had complete remission, which was better than the other two groups (5.5%, 8.3%, p less than 0.05). The following survey of all patients lasted from six months to seven years. The results suggest that a combination of PDT and chemotherapy may prove effective.

Evaluation of photodynamic therapy in advanced gastrointestinal cancer.

One hundred forty-two patients with advanced gastrointestinal cancers were treated by PDT from September 1982 to December 1988. Hematoporphyrin derivative (HpD) (5 mg/kg) was given intravenously 48-72 hours before PDT. The light source was an argon dye laser with an output beam of 630 nm. The entire tumor was irradiated with a light dose of 100-250 J/cm 2. Fifteen patients (10.6%) had a complete response, 53 (37.3%) had a partial response, and 32 (22.5%) had a mild response. In all, 100 patients (70.4%) had a response to PDT. The experiments and clinical results show that the estimated energy dose (EED) value 200-250 J/cm 2 is appropriate. All patients were treated by PDT and adjuvant chemotherapy and showed good results with a follow-up of 1-5 years. Thirteen of 15 patients in the CR group are alive (86.7%), and 12 patients survived more than 2 years (8.8%).

Review of photodynamic therapy for gastrointestinal tumours in the past 6 years in China.

Patients (142) with advanced gastrointestinal (GI) cancers were treated by photodynamic therapy (PDT) from September 1982 to December 1988. Haematoporphyrin derivative (HpD) (5 mg kg-1) was intravenously given 48-72 h prior to PDT. The light source was an argon dye laser emitting at 630 nm. The entire tumour was irradiated with a light dose of 100-250 J cm-2. Fifteen patients (10.6%) showed complete response (CR), 53 (37.3%) showed partial response (PR) and 32 (22.5%) showed mild response (MR). The clinical results show that the estimated energy dose (EED) of 200-250 J cm-2 is appropriate. All patients were treated by PDT and adjuvant chemotherapy showing good results with a follow-up of 1-5 years; 13 out of 15 patients in the CR group are alive (86.7%); 12 patients survived more than 2 years (8.8%).

Establishment of a group of murine leukemic cell lines and investigation of their biological characteristics.

An in vitro-vivo technique for establishment of cell lines on murine leukemia has been developed. Using this method, suppressive T lymphoblastic leukemia L7811-85, L7212-85, non-T, non-B lymphocytic leukemia L1210-86, B lymphocytic leukemia P 388-86 and Friend erythroleukemia FLCL cell lines have been established. Incidence of leukemia with these cell lines was 100%. Along with the increase of generations of cell lines, cell growth accelerated, generation time shortened and cloning efficiencies rose. A following up electron microscopic observation on L7811-85 and L7212-85 showed that the virus particles were "A" particles in original cells. When they became cell lines in vitro, virus particles increased and transformed into typical "C" particles with budding. An inhibitory activity relevant to leukemic cells on proliferation of leukemic cells has been observed in the supernatant of L7811-85 medium and was regarded as an "autocrine".

[Pathologic study on the treatment-effect of hematoporphyrin derivative in carcinoma of the gastric cardia].

42 patients with carcinoma of gastric cardia treated by HPD are reported. The endoscopic biopsy specimens of these patients were classified histologically before treatment. There were 2 papillary adenocarcinoma (PAC), 14 well differentiated adenocarcinoma (WDAC), 11 moderate differentiated adenocarcinoma (MDAC), 5 poor differentiated adenocarcinoma (PDAC), 6 mucinous adenocarcinoma (MAC), 1 undifferentiated carcinoma (UDC) and 3 squamous cell carcinoma (SCC). After four weeks' treatment, reexaminations by endoscopy and biopsy were done in 39 patients and operation were performed on three. Histologic changes following the treatment were degeneration, necrosis of tumor cells, and infiltration of lymphocytes and plasmacytes in the stroma to different degrees. The histologic changes were graded into H0, H1, H2 and H3 by the authors. Grades H0, H1 are considered as noneffective and grades H2, H3 as effective. Of 42 patients, 10 were H0, 21 H1, 8 H2 and 3 H3. The overall effective rate was 26.2% (11/42) which was correlated with the histologic type of carcinoma. Thus, 21.4% (3/14) of WDAC, 18% (2/11) of MDAC, 40% (2/5) of PDAC, 50% (3/6) of MAC and 100% (1/1) of UDC responded well to the treatment, but all SCC and PAC were refractory. It should also be noted that the HPD treatment was effective in patients with tumor infiltrations relatively limited and superficial in the gastric wall, but was unsatisfactory in patients with wider and deeper infiltrations.