Third-line therapy in advanced non-small cell lung cancer.

PURPOSE: With the improvements in first- and second-line treatments in non-small cell lung cancer (NSCLC), there is an increasing number of patients who receive third-line therapy. No other standard choice for third-line therapy aside from erlotinib is possible. This study investigated the efficacy and safety of single-agent chemotherapy, epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), doublet chemotherapy and chemo-targeted therapy as third-line treatment in advanced NSCLC. METHODS: This study included 233 stage IIIb or IV NSCLC patients who were retrospectively reviewed to explore the differences in survival between different treatments. RESULTS: The median progression free survival (PFS) in the EGFR-TKIs, single-agent, doublet and chemo-targeted groups was 3.83, 2.72, 2.86 and 3.29 months, respectively (p = 0.073). The median OS from the initiation of the third-line treatment was 11.16, 8.24, 8.49 and 9.33 months in the 4 groups (p=0.02). The rates of grade IIIIV toxicities were 16.4, 27.6, 57.3 and 44.0% ( p <0.001), respectively with the third-line treatment, and overall survival (OS) was prolonged in patients who never smoked (p=0.040), had adenocarcinoma (p=0.034), had good ECOG performance status (PS) (p=0.012) and achieved disease control after both first-and second-line treatments (p =0.031). CONCLUSION: Patients with advanced NSCLC who never smoked, had adenocarcinoma, have good PS, and good disease control from the first- and second-line therapies could benefit more with third-line treatment. EGFR-TKIs and chemo-targeted therapy showed increased OS compared with single-agent and doublet chemotherapy.

Analysis of hypothermia factors for elderly patients with malnutrition during proximal femoral nail antirota-tion internal fixation under general anesthesia / 局解手术学杂志

Objective To analyze the incidence and risk factors of hypothermia in elderly patients with malnutrition during proximal femoral nail antirotation(PFNA)internal fixation under general anesthesia.Methods A total of 139 elderly patients underwent PFNA internal fixation under general anesthesia were selected,and the nutritional status scores 1 day before surgery ranged from 0 to 11 points.Univariate and multivariate Logistic binary regression analysis was performed to analyze the related factors that may lead to intraoperative hypothermia.Results Among 139 elderly patients with preoperative nutritional scores of 0 to 11 points,79 cases(56.83%)developed intraoperative hypothermia.The results of univariate and multivariate Logistic binary regression analysis suggested that age≥75 years old,mini nutritional assessment short form(MNA-SF)nutritional score 0 to 7 points,BMI<18.5 kg/m2,duration of general anesthesia≥2 hours,intraoperative flushing fluid volume≥1 000 mL and intraoperative fluid volume≥1 000 mL were the risk factors for the occurrence of intraoperative hypothermia in elderly patients(OR>1,P<0.05).The use of warm blanket insulation was the protective factor against the occurrence of intraoperative hypothermia(OR<1,P<0.05).Conclusion The incidence of intraoperative hypothermia during PFNA internal fixation under general anesthesia in elderly patients with mainutrition before operation is high,and patients with poor nutritional status are more likely to develop intraoperative hypothermia.Patients with older age,poor nutritional status,lower BMI,longer duration of general anesthesia,and more intraoperative flushing fluid volume and intraoperative fluid volume are likely to lead to intraoperative hypothermia.The use of warm blanket can reduce the incidence of intraoperative hypothermia.

Review considerations on the design and evaluation of the oral sensory features in pediatric medications / 药学学报

Recent years, China has released a series of policies to encourage drug research and development in pediatric populations, aiming to meet pediatric populations' medical needs. Because of the physical and psychological developmental characteristics, tolerance of aversive feelings when taking medications are different between pediatric population and adults. So pediatric populations are at a relatively higher risk of not taking medications as prescribed when the medication tasted unpleasant. Therefore, sound design and evaluation of oral sensory features have important clinical significance and value in developing pediatric medications. "Technical guidance for the design and evaluation of the oral sensory features of pediatric drugs (trial version) " was released in November 2022, by Centre for Drug Evaluation, National Medical Products Administration of China. Based on the guidance, this article will introduce the drafting background and review considerations, hoping to provide reference for the design and evaluation of oral sensory features, and promote drug developing in pediatric population.

Modern Pharmacological Effect of Zhishi Xiebai Guizhitang： A Review / 中国实验方剂学杂志

Zhishi Xiebai Guizhitang is a classical prescription for the treatment of chest impediment with the method of warming Yang. It is included in the Catalogue of Ancient Classical Prescriptions issued by the National Administration of Traditional Chinese Medicine （First Batch）， with the effect of activating Yang， dissipating mass， moving Qi and resolving phlegm. Its main symptoms include chest fullness and pain， or even chest pain radiating to the back， wheezing， coughing， shortness of breath， and Qi reversal from the hypochondrium. In modern traditional Chinese medicine， Zhishi Xiebai Guizhitang is clinically used in the treatment of cardiovascular system， digestive system， respiratory system and other diseases， among which coronary heart disease， unstable angina pectoris， myocardial infarction， sinus bradycardia and other cardiovascular diseases have particularly significant effects. This paper reviewed the pharmacological studies of Zhishi Xiebai Guizhitang in the past 10 years. The results showed that each single medicine and the whole prescription alleviated the above cardiovascular diseases to a certain extent， with the pharmacological effects of improving intravascular environment， myocardial ischemia， myocardial ischemia-reperfusion injury， and myocardial hypoxia， anti-inflammation， plaque stabilisation， etc.， and the pharmacological mechanism involved the regulation of relevant active substances in vivo as well as related signaling pathways and ion channels， mainly including thromboxane B2 （TXB2）， prostacyclin I2（PGI2） and phosphatidylinositol 3-kinases/protein kinase B/endothelial nitric oxide synthase （PI3K/Akt/eNOS） signaling pathways， and ATP-sensitive potassium channels. In addition， the relationship between the pharmacological effects of some single medicines and transient receptor potential ankyrin 1 （TRPA1） has been reported that TRPA1 is a key to understanding the mechanism of Zhishi Xiebai Guizhitang in treating cardiovascular diseases， which is worth of further study.

Study on equivalence between micro kinetic chromogenic assay and kinetic chromogenic assay / 中国药理学通报

Aim To evaluate the equivalence between micro kinetic chromogenic assay anrl kinetic chromogenic assay in order to provide data support for the use of alternative methods.Methods Detection conditions; micro kinetic chromogenic assay and kinetic chromogenic assay limulus reagent were used, sample amount of each well and limulus reagent was 25 jxL ( kinetic chromogenic assay was 100 jxL) , detection wavelength was 405 nm, ONSET OD value was 0.03, and half- well elisa plate was used for detection ( kinetic chromogenic assay was ordinary ELISA plate).The equivalence of the two methods was evaluated by various statistical methods, such as equivalence test, in collaboration with four laboratories in China.Results The results of one-way an OVA, paired T test and equivalence test were consistent, indicating that there were some differences between the existing kinetic chromogenic assay of different manufacturers, while there was no significant difference between the trace or conventional amount of reagent used by each manufacturer.Conclusions Micro kinetic chromogenic assay is e- quivalent to existing reagents in terms of accuracy and recoverv.J.

Assessment of information security literacy and its risk factors of disease control and prevention information system in Jinshan District / 上海预防医学

Objective:To assess the current situation of information security literacy， and determine its factors. Methods:Literature review and Delphi method were used to design a questionnaire on information security literacy. All users of disease control information system in Jinshan District，Shanghai were investigated. The questionnaire included information security related knowledge， awareness， role cognition， and behavior. Results:The overall proportion of information security literacy was determined to be 7.98%. Information security knowledge， awareness， role cognition， and behavior was identified in 17.18%， 37.42%， 62.58%， and 38.04% of the users， respectively. Sex， age and type of information system account were associated with the information security literacy. Conclusion:Information security literacy remains low in Jinshan District， which may not meet the current requirement in work. Particularly， information security behavior is at risk， which warrants further improvement in the information security management.

Exploration on origin of Simiao Yong'an Decoction / 中国中药杂志

Simiao Yong'an Decoction is composed of Lonicerae Japonicae Flos, Scrophulariae Radix, Angelicae Sinensis Radix, Glycyrrhizae Radix et Rhizome, which was chosen as one of the 100 classic prescriptions in Catalogue of Ancient Classics Prescription(the first batch). Through tracing to the source, It was found that the Simiao Yong'an Decoction(but not named) originated from the Shi Shi Mi Lu, and was later cited by books such as Ancient and Modern Book Integration-Full Record of Medical Department and New Edition of Useful Prescriptions. Literature shows that this prescription was not named until first reported in the Effect of Traditional Chinese Medicine on Arterial Embolism Gangrene in 1956 by a journalist LYU Min. This article recorded that SHIJIA Baoshan, a monk from Hebei Province, used self-named "Simiao Yong'an Decoction" to treat local arterial embolic gangrene. After comparison, there was two difference between ancient books and SHIJIA Baoshan's records. Firstly, according to ancient books, the composition and dosage of Simiao Yong'an Decoction is Lonicerae Japonicae Flos 90 g, Scrophulariae Radix 90 g, Angelicae Sinensis Radix 60 g, Glycyrrhizae Radix et Rhizome 30 g", and the ratio is 3∶3∶2∶1. By SHIJIA Baoshan's record, the composition and dosage are: Lonicerae Japonicae Flos 66 g, Scrophulariae Radix 132 g, Angelicae Sinensis Radix 99 g, Glycyrrhizae Radix et Rhizome 33 g, and the ratio changed to 2∶4∶3∶1. Secondly, ancient books show that patients can be healed after taking seven or ten days of the previous prescription, however, it would take 3 or 4 months, even 7 months in SHIJIA Baoshan's records. It can be considered that the previous prescription should be used at the beginning of gangrene, while the modified Simiao Yong'an Decoction by SHIJIA Baoshan is widely used in the middle and late stages of gangrene, even the critical condition, that is the reason for longer treatment and larger dosage. Nowadays, Simiao Yong'an Decoction is not limited to the treatment of gangrene and bulla in clinic. Relevant studies have confirmed that Simiao Yong'an Decoction has the effects such as anti-inflammatory, plaque stabilization, lipid-lowering, vascular protection, improvement of hemorheology, anticoagulation, inhibition of thrombosis and fibrinolysis, etc. In the follow-up, we should carry out the analysis of the compatibility of this four medicines, and redefine the scope of its clinical application under the theory of traditional Chinese medicine.

Correlation of C-MYC Protein, MDSC and Th17 Cells with Pathogenesis of Myeloma in Different Clinical Stages / 中国实验血液学杂志

OBJECTIVE@#To investigate the correlation of C-MYC protein with MDSC, Th17 cells and the pathogenesis of myeloma in different clinical stages.@*METHODS@#A total of 65 patients with multiple myeloma treated in our hospital were selected as MM group, and 30 healthy subjects were selected as control group. The positive expression rate of C-MYC protein in bone marrow tissue, and the ratios of peripheral blood MDSC and Th17 cells were compared among the two groups, and the correlation of C-MYC protein, the ratio of MDSC, Th17 cells with onset of myeloma at different clinical stages, the relationship of the expression of C-MYC protein with the ratio of MDSC/Th17 cells and the clinical parameters of MM was analyzed. Also, the diagnostic value of single diagnosis and combined diagnosis was compared.@*RESULTS@#The positive expression rate of C-MYC protein in bone marrow, the ratio of MDSC and Th17 cells in peripheral blood in MM group were significantly higher than those in normal control group(P＜0.05); the positive expression rate of C-MYC protein, MDSC and Th17 cells in patients at ISS stage Ⅰ, Ⅱ and Ⅲ MM showed an increasing trend (r=0.432, r=0.401, r=0.351); the correlation between the ratio of MDSC, Th17 cells and the positive expression rate of C-MYC protein in MM patients was positive (r=0.415, r=0.417); the area under ROC curve (AUC) of combined diagnosis was significantly larger than that of single index diagnosis (C-MYC protein, MDSC cells, Th17 cells)(P＜0.05). There was no correlation between the expression of C-MYC protein, the proportion of MDSC, Th17 cells and sex or age in MM patients (P＞0.05).@*CONCLUSION@#The positive expression rate of C-MYC protein and the proportion of MDSC and Th17 cells in MM patients significantly increase, which positively correlates with clinical ISS stagin.

Comparison of minimal residual disease in multiple myeloma patients detected by 8-color panels and next generation flow cytometry / 中华血液学杂志

Objective: To compare the sensitivity of 8-color panels and next generation flow cytometry (NGF) for detecting minimal residual disease of multiple myeloma patients. Methods: 8-color-membrane antigens (8C-Mem) panel was built including CD45, CD38, CD138, CD19, CD56, CD81, CD27 and CD117 to identify the plasma cells, while 8-color-cytoplasmic antigens (8C-Cyto) panel was built including CD45, CD38, CD138, CD19, CD56, CD81, cKappa (cK) and cLambda (cλ) , and 8-color-two-tubes (8C-2tubes) panel were built including 8C-Mem and 8C-Cyto panels, the data of three groups was analyzed by Diva software. NGF uses Infinicyt software to fuse 8C-2tubes data to further analyze the expression of plasma antigens. Bone marrow aspiration obtained from 20 controls and 76 multiple myeloma patients who achieved complete remission were measured and analyzed. Results: Positive MRD samples were discriminated in 88.2% of the specimen evaluated through either abnormal plasma cells (aPCs) or clonal plasma cells (cPCs) by NGF antigens panel, Among of them, consistency was 94.7%. The median percentage of cPCs was 0.3530%, The lowest sensitivity of NGF was 0.0003%. In 8-color panels, the positive MRD rates of 8C-Mem, 8C-Cyto and 8C-2tubes panels were 84.2%, 85.5% and 86.8%, respectively, which lower than that of NGF (P<0.001) . The positive MRD rate of 8C-Mem and 8C-Cyto panels were lower than that of 8C-2tubes panel (P<0.001) , and the positive MRD rate of 8C-Mem panel was lower than that of 8C-Cyto panel (P<0.001) . Sensitivity and specificity of NGF was higher than that of 8-color panels. 8C-2tubes panel has the best sensitivity, accuracy, negative predicted value, positive predicted value and specificity than other 8-color panels. However, huge data and low efficiency for analysis is the disadvantage. 8C-Cyto panel was the second choice, and 8C-Mem panel was the last. Conclusions: Membrane and cytoplasmic light chain is a better method for multiple myeloma-MRD detection and NGF panel is an ideal approach. 8C-Cyto panel is recommended in 8-MFC groups.

Chiral Probe for Recognition of Landiolol Hydrochloride and Its Stereoisomer by Mass Spectrometry / 分析化学

In this work,two chiral chloride probes were used to differentiate landiolol hydrochloride by mass spectrometry. Two chiral chloride probe reagents, N-(p-Tosyl)-L-phenylalaninyl chloride (TSPC) and (-)-Camphanic acid chloride, were chosen to react with landiolol hydrochloride and its stereoisomers to form covalent bonding derivatives, which enlarged the difference of stereo structure between landiolol and its stereoisomers. Result of tandem mass spectrometry showed that fragment from derivative products prefers to losing water to form fragment ions m/z 793 and m/z 672. The relative abundance of ions m/z 793 and m/z 672 was quite different in each isomer. The fragment ions m/z 603 from (-)-Camphanic acid chloride derivative products showed distinction relative abundance because of the different stability of each stereoisomers, which gave rise to the enlarged difference of stereo structure between landiolol and its stereoisomers. By comparing the different relative abundance ratio of analyte and each stereoisomer in MS/MS spectra, we could realize recognization landiolol hydrochloride and its stereoisomers. Accurate masses of precursor and fragment ions were confirmed on an IT-TOF mass spectrometer. This method by using ion-trap mass spectrometry could rapidly and simply differentiate landiolol hydrochloride and its stereoisomers. This work could also contribute to differentiation and discrimination of landiolol hydrochloride and its stereoisomers.

Study on chiral recognition for the glimepiride and glimepiride-cis-isomer by applying three amino acid (D-Lysine, L-Glutamine and L-Tyrosine) as chiral probes based on electrospray ionization mass spectrometry / 药物评价研究

Objective Chiral recognition for the glimepiride and glimepiride-cis-isomer by applying three amino acid (D-Lysine,L-Glutamine and L-Tyrosine) as chiral probes based on electrospray ionization mass spectrometry (ESI-MS) was achieved.Methods glimepiride/glimepiride-cis-isomer solutions were mixed with three amino acid solutions.The complex was extracted by ESI-MS and then the fragmentation abundance was investigated applying collision induced dissociation (CID) by MS/MS,which is the basis of chiral recognition for glimepiride and glimepiride-cis-isomer.Results Chiral recognition effect was achieved with the recognition rate (R) 1.61,2.92 and 2.17 for D-Lysine,L-Glutamine and L-Tyrosine respectively.Conclusion 3 kinds ofchiral amino acids were used as probes to distinguish between stereoisomers,and rapid identification of glimepiride and glimepiride cis isomer by mass spectrometry come true for the first time.

A survey of sleep problems and influencing factors among preschoolers / 中国学校卫生

Objective@#To investigate the prevalence of sleep problems and influencing factors among preschoolers, so as to provide a reference for healthy sleep behaviors among preschoolers.@*Methods@#From December 2017 to June 2018, a questionnaires study was administered to parents of 8 456 preschoolers from kindergartens in Yangzhou, Zhenjiang and Xuzhou by using random cluster sampling method. Demographic characteristics, screen time, sleep patterns and the Children s Sleep Habits Questionnaire (CSHQ) were colleted.@*Results@#The average night sleep duration was (9.91±0.64)h, the rate of sleep deprivation was 51.7%, which increased with age ( χ 2 trend =34.19, P <0.01). The total scores of CSHQ were (49.46±5.02), and the prevalence of sleep problems was 95.0%, with the prevalence of specific sleep problems ranged from 2.3% to 76.4%. Multivariate Logistic regression analysis showed that only child, mothers age, parental education, and household economic status was significantly associated the sleep problems ( P <0.05).@*Conclusion@#The prevalence of sleep problems among preschool children is more prominent, varies by only child, parental education and household economic status. Parents and society should raise awareness of sleep problems.

Thawing cycle sequential embryo transfer in patients with repeated implantation failure / 天津医药

Objective To compare the outcome of in vitro fertilization (IVF) between sequential embryo transfer and simple blastocyst transplantation in patients with previous multiple IVF failures. Methods A total of 170 patients with repeated implantation failure were divided into sequential transfer group (n=71) and blastocyst transfer only group (n=99). A retrospective matched case-control analysis was made for the medical files of 71 patients who underwent sequential transfer of D3 embryos and blastocysts. The control group included 99 matched women who underwent embryo transfer on D5/6 only. All of the patients in two groups used the same protocols of emdometrium preparation (natural cycle or hormone-replacement cycle) and ultrasound-guided transplantation. The embryo implantation rate and clinical pregnancy rate were compared and analyzed between two groups. Results Sequential transfer of embryos resulted in a clinical pregnancy rate of 60.6%compared with that of 31.3%following D5/6 embryo transfer, and the implantation rate was 34.8%and 23.8%respectively (P<0.05). Although the total number of transfered embryos were higher in sequential transfer group than that of blastula transfer only group, the number of D5/6 embryo transfered in sequential transfer group were less than blastula transfer only group (P<0.05). And the number of high quality blastula transfered showed no statistical significant difference between two groups. There were 20 cases of twin and 5 cases of triplet pregnancy in sequential transfer group, which were 5 cases and 1 case in blastula transfer only group respectively. While, there was no case of muliple pregnancy beyond triplet in both groups Conclusion Sequential transfer of embryos can be used for women with repeated IVF cycles. The program avoids the possibility of eliminating the transplant, and which is effective in patients with more transplant embryos.

Efficacy and Safety of Bortezomib in Multiple Myeloma Patients with Hepatitis B: A Multicenter Retrospective Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The efficacy and safety evidence of bortezomib in multiple myeloma (MM) patients with hepatitis B is vacant. This study aimed to investigate the efficacy and safety of bortezomib in MM patients with hepatitis B in China.</p><p><b>METHODS</b>From 2006 to 2011, 739 newly diagnosed MM patients were screened for serum hepatitis B virus (HBV) biomarkers. HBV-infected patients were followed for HBV reactivation by monitoring of serum alanine transaminase (ALT) and HBV DNA load. The pattern of HBV reactivation in relation to bortezomib was evaluated. Seven hundred thirty-nine MM patients were included in this study.</p><p><b>RESULTS</b>The prevalence of MM patients infected with HBV was 3.4% (n = 25), of which 17 cases were treated with bortezomib. Bortezomib had no significant influence on liver function (ALT before and after treatment: 36.69 ± 8.90 U/L vs. 11.31 ± 2.74 U/L, P = 0.19) and HBV DNA of MM patients with HBV (detectable HBV DNA percentage: 5.9% vs. 11.8%, P = 0.12).</p><p><b>CONCLUSIONS</b>Bortezomib can be used safely and effectively in MM patients with hepatitis B. HBV prophylaxis and surveillance are recommended during the MM treatment.</p>

Discussion of HPLC Column Management in Analytical Laboratory / 中国药师

HPLC is widely applied in the analysis of chemical drugs. In order to regulate the use and maintenance of HPLC col-umn and guarantee the analysis quality of HPLC, the classified management of HPLC column was explored in the paper from the follow-ing five aspects:file establishment, recipient and return management, column performance evaluation, information accumulation of ap-plication range, and maintenance and abandonment of HPLC column.

Clinical significance of serum vascular endothelial growth factor in patients with multiple myeloma / 中国实验血液学杂志

This study was purposed to investigate the relation of serum vascular endothelial growth factor (VEGF) levels with clinical types and therapeutic efficacy of multiple myeloma (MM), and to analyze the significance of VEGF in MM. The levels of serum VEGF were detected by enzyme-linked immunosorbent assay (ELISA) technique in 76 patients with MM. The relationship between the serum VEGF levels with MM patients' age, stages, types, and efficacy were analyzed. The results showed that the patients who were less than 65 years old had higher serum VEGF levels than elder patients, however, the difference between them had no statistical significance (P > 0.05). The VEGF level was the highest in IgG type patients, and then in light chain type, lowest in IgA type, however there were no statistical differences between them (P > 0.05). Patients of DS stage III had higher VEGF level than that of stage II, and there was also no statistical difference (P > 0.25). Patients of ISS stage I had lower VEGF level than that of stage II and III, and it also showed no statistical difference (P > 0.05). After treatment, patients obtained complete remission (CR) or very good partial remission (VGPR) had decrease of serum VEGF level, however, patients obtained less than partial remission (PR) had increase of serum VEGF level. Patients were divided into two groups according serum VEGF level ( ≤ 150 ng/L), patients with high VEGF levels had short overall survival time, there was statistical difference (P = 0.03). It is concluded that the serum VEGF level of MM patients dose not relate with age, clinical stages and M protein types; however, there was a certain association between overall survival and serum VEGF level, and the later may be one of poor prognostic factors.

Effect of Recombinant Human Granulocyte∕macrophage Colony_stimulating Factor and Nano_silver on Neovascularization in Healing Process of Skin with Deep II Degree Burn / 医药导报

Objective To obserVe the effect of recombinant human granulocyte∕macroPhage colony stimulating factor ( rhGM_CSF) and nano_silVer as treatment for skin with deeP II degree burn. Methods DeeP II degree burn Wistar rat model was established. The rats were randomly diVided into three grouPs,Petrolatum treatment grouP (grouP A,n=30),nano_silVer treatment grouP (grouP B,n=30),and rhGM_CSF treatment grouP (grouP C,n=30). The Pathological changes of wound of the three grouPs were obserVed 1,4,7,10,14 and 21 days after the treatment. The concentration of VEGF in serums was measured with ELISA. The leVels of HIF_1α mRNA exPression were detected by RT_PCR. Results On day 10, neoVascularization deVeloPed in grouPs A, B and C. Healing rate of the wound was the highest in grouP C, lowest in grouP A, with significant differences among the three grouPs on day 14 and day 21 (P<0. 05). VEGF leVel Peaked on day 14 in grouP A,and on day 10 in grouPs B and C. There were significant differences in VEGF leVel on day 1 between grouP A and grouPs B,C,on day 7 between grouP A and grouP C,on day 10,14 and 21 among the three grouPs (P<0. 05),but no significant differences on day 4 among the three grouPs. Conclusion rhGM_CSF and nano_silVer treatment can accelerate neoVascularization of wound,and rhGM_CSF is better than nano_silVer.

Microvascular permeability of brain astrocytoma with contrast-enhanced magnetic resonance imaging: correlation analysis with histopathologic grade / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The degree of pathological microvascular proliferation is an important element in evaluation of the astrocytoma grade. This study was aimed to quantitatively assess the microvascular permeability of brain astrocytoma with the volume transfer constant (K(trans)) and volume of extravascular extracellular space per unit volume of tissue (Ve) from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and to evaluate the effectiveness of the K(trans) and Ve in the grading of astrocytoma.</p><p><b>METHODS</b>The highest values of the K(trans) and Ve of 67 patients with astrocytoma (27 with grade II, 12 with grade III, and 28 with grade IV) were obtained. The comparisons of the differences of the K(trans) and Ve between the different grades were conducted using the Mann-Whitney rank-sum tests. Spearman's rank correlation coefficients were determined between K(trans) values, Ve values and astrocytoma grades. Receiver operating characteristic (ROC) curve analyses were performed to determine the cut-off values for the K(trans) and Ve to distinguish between the different grades of astrocytoma.</p><p><b>RESULTS</b>There were significant differences (P < 0.001) between the different grades in the K(trans) values and Ve values, except for grades III and IV. The K(trans) values and Ve values were both correlated with astrocytoma grades (both P < 0.001). The ROC curve analyses showed that the cut-off values for the K(trans) and Ve provided the best combination of sensitivity and specificity in distinguishing between grade II and grade III or IV astrocytomas.</p><p><b>CONCLUSIONS</b>DCE-MRI can play an important role in assessing the microvascular permeability and the grading of brain astrocytoma.</p>

Retroperitoneal hemangiopericytoma: case report and literature review / 中华医学杂志(英文版)

Retroperitoneal hemangiopericytoma is a kind of uncommon tumor. We report a case of 41-year-old man who was diagnosed retroperitoneal tumor without significant symptoms by abdominal ultrasonography. Abdominal CT and MRI scans show a 6 cm × 5 cm solid tumor delineated clearly from adjacent organs. Excision of the tumor was performed and the histopathological examination confirmed the diagnosis of hemangiopericytoma.

Quantitative evaluation of benign meningioma and hemangiopericytoma with peritumoral brain edema by 64-slice CT perfusion imaging / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hemangiopericytomas (HPCs) have a relentless tendency for local recurrence and metastases, differentiating between benign meningiomas and HPCs before surgery is important for both treatment planning and the prognosis appraisal. The purpose of this study was to evaluate the correlations between CT perfusion parameters and microvessel density (MVD) in extra-axial tumors and the possible role of CT perfusion imaging in preoperatively differentiating benign meningiomas and HPCs.</p><p><b>METHODS</b>Seventeen patients with benign meningiomas and peritumoral edema, 12 patients with HPCs and peritumoral edema underwent 64-slice CT perfusion imaging pre-operation. Perfusion was calculated using the Patlak method. The quantitative parameters, include cerebral blood volume (CBV), permeability surface (PS) of parenchyma, peritumoral edema among benign meningiomas and HPCs were compared respectively. CBV and PS in parenchyma, peritumoral edema of benign meningiomas and HPCs were also compared to that of the contrallateral normal white matter respectively. The correlations between CBV, PS of tumoral parenchyma and MVD were examined.</p><p><b>RESULTS</b>The value of CBV and PS in parenchyma of HPCs were significantly higher than that of benign meningiomas (P < 0.05), while the values of CBV and PS in peritumoral edema of benign meningiomas and HPCs were not significantly different (P > 0.05). MVD in parenchyma of HPCs were significantly higher than that of benign meningiomas (P < 0.05). There were positive correlations between CBV and MVD (r = 0.648, P < 0.05), PS and MVD (r = 0.541, P < 0.05) respectively. Furthermore, the value of CBV and PS in parenchyma of benign meningiomas and HPCs were significantly higher than that of contrallateral normal white matter (P < 0.05), the value of CBV in peritumoral edema of benign meningiomas and HPCs were significantly lower than that of contrallateral normal white matter (P < 0.05), while the value of PS in peritumoral edema of benign meningiomas and HPCs were not significantly different with that of contrallateral normal white matter (P > 0.05).</p><p><b>CONCLUSIONS</b>CT perfusion imaging can provide critical information on the vascularity of HPC and benign meningiomas. Determination of maximal CBV and corresponding PS values in the parenchyma may be useful in the preoperative differentiating HPC from benign meningiomas.</p>