Practice guideline for patients with hyperuricemia/gout / 中华内科杂志

Hyperuricemia/gout is a common metabolic disease in China, which is a serious threat to people′s health. In clinical practice, the standardization of prevention and diagnosis and the rate of treat-to-target need to be improved. There is still a lack of education for the patients about the understanding of clinical guidelines, the disease knowledge and the importance of cooperating with doctors to carry out diagnosis and treatment. From the most concerned issues of the patients, we established the hyperuricemia/gout patient practice guideline working group with multidisciplinary physicians and patients. Seventeen opinions, as the hyperuricemia/gout patient practice guidelines, are proposed in accordance with the relevant principles of the "WHO guidelines development manual" , and with the international normative process, aiming to improve the patients compliance, improve the level of health management of the disease.

Multimodel functional MRI in the differential diagnosis of breast mucinous carcinoma and phyllodes tu-mor(≥3 cm) / 实用医学杂志

Objective To investigate the application value of functional MRI in the differential diagnosis between breast mucinous carcinoma and phyllodes tumor(≥ 3 cm). Methods 55 cases of breast mucinous adeno-carcinoma and phyllodes tumors(≥ 3 cm)from January 2012 to December 2017 were retrospectively analyzed. MRI features of 20 mucinous carcinomas and 35 phyllodes tumors were analyzed,compared with pathology. Re-sults There were 20 cases of breast mucinous carcinoma in current study,including 14 cases of pure mucinous carcinoma and 6 cases of mixed mucinous carcinoma. There were 35 cases of phyllodes tumors,including 9 be-nign,18 borderline and 8 malignant cases. There was no significant difference in T1WI signal and enhancement mode between breast mucinous carcinoma and phyllodes tumors. There were significant differences in age,long di-ameter,morphology,lobulation,border,ADC value,EER,T2WI signal and TIC curve pattern(P < 0.05). The area under ROC(AUC)of ADC value and EER for breast mucinous adenocarcinoma and phyllodes tumor was 0.7036 and 0.8029,respectively. Conclusions Multi-model functional MRI can effectively distinguish breast mucinous adenocarcinoma from phyllodes tumor(≥ 3 cm),and EER is more accurate than ADC value.

The characteristics of the surface electromyographic signals recorded from submental and infrahyoid muscles when swallowing in patients with nasopharyngeal carcinoma after radiotherapy / 中华物理医学与康复杂志

Objective To study the surface electromyographic signal characteristics of submental and infrahyoid muscles when swallowing in patients with nasopharyngeal carcinoma (NPC) following radiotherapy.Methods Fifteen post-radiotherapy NPC patients with pharyngeal dysphagia confirmed by videofluoroscopie swallowing study (VFSS) were selected into the patient group,while another 15 healthy subjects were recruited into the healthy group.Surface electomyography (sEMG) was used to collect sEMG signals from submental muscles and infrahyoid muscles during both dry and 3 ml thick liquid swallowing,and sEMG duration,average amplitude and peak amplitude parameters were compared between the two groups.Results Compared with healthy subjects,the patient group showed significantly longer sEMG duration of submental muscles and infrahyoid muscles during dry swallowing and 3 ml thick liquid swallowing (P＜0.05).Moreover,significantly longer sEMG duration of submental muscles and infrahyoid muscles was observed when swallowing 3 ml thick liquid,compared with dry swallowing (P＜0.05).The average sEMG amplitude and peak amplitude of submental muscles and infrahyoid muscles of patients when dry swallowing and 3 ml thick liquid swallowing were both significantly higher than those of healthy subjects (P＜0.05).Conclusion Submental muscles and infrahyoid muscles manifested enhanced contractions during swallowing in NPC patients with dysphagia,which played a compensatory role after radiotherapy.

Correlation between apparent diffusion coefficient values and histopathological grading of cerebral gliomas / 中华神经医学杂志

Objective To investigate the relationship between apparent diffusion coefficient (ADC) values and histopathological grading of cerebral gliomas.Methods A retrospective analysis was performed to investigate the clinical data of 76 patients with cerebral gliomas,admitted to our hospital from April 2013 to December 2016.According to Classification Criteria of Central Nervous System Tumors by WHO in 2016,these 76 patients were divided into low grade cerebral glioma group (grading Ⅰ-Ⅱ,n=21),moderate grade cerebral glioma group (grading Ⅲ,n=23) and high grade cerebral glioma group (grading Ⅳ,n=32).MR imaging,enhanced MR imaging and diffusion weighted imaging (3.0T,b value:1000 s/mm2) were performed to detect the ADC values.One-way ANOVA was used to compare ADC values between the 3 different histopathological groups.Spearman correlation analysis was used to analyze the correlation between histopathological grading of cerebral gliomas and ADC values.A receiver operating characteristic curve (ROC) analysis was performed to evaluate the diagnostic efficiency of ADC values.Results The ADC values of low grade,moderate grade and high grade cerebral gliomas were (1.37±0.26)×103 mm2/s,(0.97±0.11)×103 mm2/s,(0.75±0.13)×10-3 mm2/s,respectively;statistically significant differences were observed between each two groups (P＜0.05).There was a negative correlation between ADC values and histopathological grading of cerebral gliomas (r=-0.868,P=-0.000).ROC analysis showed that the optimal cutoff point of ADC values was 1.11 × 10.3 mm2/s in diagnosing low grade cerebral gliomas,enjoying sensitivity and specificity of differential diagnosis of 95.2％ and 96.4％;ROC curve showed that the optimal cutoffpoint of ADC values was 0.93×10-3 mm2/s in diagnosing high cerebral gliomas,enjoying sensitivity and specificity of differential diagnosis of 81.8％ and 93.7％.Conclusion ADC values are important for predicting histopathological grading of cerebral gliomas.

MRI Features of Mucinous Breast Carcinoma and the Correlation with Biological Prognostic Factors / 中山大学学报(医学科学版)

[Objective]To explore the MRI features of the mucinous breast carcinoma and the correlation with biological prognos?tic factors.[Methods]MRI features of 35 pure and 15 mixed mucinous carcinomas were retrospectively analyzed. MR images were reviewed for shape,margin,the signal intensity,enhancement patterns of tumors and DWI features. All the patients were detected by immunohistochemical staining with expression of ER,PR,CerbB-2,Ki-67 and Her-2. Correlations between the pure and mixed mucinous breast carcinoma and prognostic factors were analyzed.[Results]16 oval masses(16/35,45.7%)and 10 circular masses (10/35,28.6%)were found in 35 pure mucinous breast carcinomas with clear boundary(26/35,74.3%)and lobulated shape(31/35,88.6%);9 irregular masses(9/15,60%)were found in mixed mucinous breast carcinomas with unclear boundary(13/15, 86.7%). Very high signal intensity on T2-weighted images was found in 33 pure mucinous carcinomas(33/35,94.3%)and 11 mixed mucinous carcinomas showed mixed signal intensity(11/15,73.3%). Early enhancement rate was(114.7 ± 9.1)% for pure muci?nous carcinomas and(165.6 ± 14.3)%for mixed mucinous carcinomas. 28 pure mucinous tumors demonstrated persistent enhancing pattern on time-signal intensity curve ,7 pure mucinous tumors demonstrated plateau pattern and 7 mixed mucinous carcinomas showed plateau pattern and washout pattern respectively. Mean ADC value was(1.91 ± 0.06)×10-3 mm2/s for pure mucinous carcino?mas and(1.13±0.08)×10-3mm2/s for mixed mucinous carcinomas. There was significant difference with morphology,boundary,T2WI signal,early enhancement rate,time-signal intensity curve,ADC value between pure and mixed mucinous breast carcinoma(P <0.05). There was significant difference between pure and mixed mucinous breast carcinoma with Her-2 and Ki-67 expression(P <0.05).[Conclusion]MRI could identify PMBC and MMBC from the shape,the signal intensity,dynamic enhancement and ADC val?ue,and PMBC had distinctive MRI features. The prognosis of MMBC is worse than that of PMBC form correlation between biological prognostic factors and mucinous breast carcinoma.

Vertigo due to neurovascular cross-compression: diagnosis and treatment / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical characteristics, pathological mechanism, diagnose, differential diagnosis and the treatment of vascular compressive vestibular neuropathy.@*METHOD@#The authors retrospectively studied 2 cases of vascular compressive vestibular neuropathy about clinical characteristics, auditory tests, vestibular tests and imaging examine results, pharmacotherapy results and reviewed the related documents.@*RESULT@#There were some common clinical characteristics: (1) Vertigo and disequilibrium could be elicited by any physical activity and head movement and abated with complete bed rest; (2) Symptoms and signs can't be improved by vestibular suppressant medications; (3) When taken Dix-Hallpike test, true vertigo or a spinning sensation appeared during head movement, when head skilled at any position,the symptoms disappeared; (4) The suffering lateral often showed high frequency sensorineural hearing loss ,the ABR of the suffering lateral showed prolonged inter wave latency of I-III wave; (5) Vestibular tests showed central lesion; (6) Occupying lesion can be ruled out by CT and MRI, MRI showed neurovascular compression of vestibular nerve; (7) Taking carbamazepine plus baclofen or only Tegretol orally can alleviate symptoms. A great deal of surgeries confirmed neurovascular compression of cranial nerve U as a disease entity, the offending artery mainly anterior inferior cerebellar artery. Microvascular decompression of cranial nerve VIII can successfully relieve vertigo.@*CONCLUSION@#Neurovascular compression of cranial nerve VIII is a disease entity beyond question. It's major characters were vertigo and disequilibrium which elicited by any physical activity and head movement, magnetic resonance tomographic angiography can give valuable information for diagnosis and treatment. Microvascular decompression can effectively relieve vertigo.

The application of spiral CT in diagnosing the otitis media with cholesteatoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the application of spiral CT imaging of temporal bone in diagnosing the chronic otitis media with cholesteatoma.@*METHOD@#The clinical data and spiral CT manifestation of 104 cases of chronic otitis media with cholesteatoma were retrospectively analyzed. All the diagnoses were confirmed by operation and pathology.@*RESULT@#Spiral CT imaging could accurately show the signs of soft-tissue occupancy and bony-erosion of by cholesteatoma in middle ear which originated from various sites and of various sizes. Comparing the CT imaging before surgery and the findings during the operation, the consistency in bone erosion was 89.1%, in soft-tissue occupancy was 94.4% and in invasion of ossicle chain was 89.3%.@*CONCLUSION@#Spiral CT imaging plays an important role in diagnosing cholesteatoma and especially the bony-erosion and the soft-tissue occupancy, which can provide crucial information for the surgery.