Objective To introduce the current value of multi-detector row CT (MDCT) and magnetic resonance imaging (MRI) techniques on evaluation of diffuse hepatic parenchymal diseases.Methods By literature review, the application and recent advances of various kinds of MDCT and MR imaging techniques in evaluating diffuse hepatic parenchymal diseases were summarized. Results There were three kinds of diffuse liver parenchyma diseases, which were the diseases of storage, vascular and inflammatory. The morphology changes of diffuse liver parenchyma diseases could be demonstrated well by MDCT. MRI, especially MR functional imaging could reflect the morphology changes, and cellular metabolic activity of the liver, which provided qualitative and quantitative information for the diagnosis and evaluation of therapeutic effect on diffuse liver parenchyma diseases. Conclusion MR imaging techniques, especially those functional techniques, developed rapidly and had practical value in both the diagnosis and severity assessment of hepatic fibrosis.
ObjectiveTo summarize the application of dual-energy CT scanning technology in the liver. MethodsTo search the relevant literatures at home and abroad, then the application of dual-energy CT scanning technology in focal liver lesions, diffuse liver lesions were analyzed and summarized. ResultsDual-energy CT scanning technology can improve detection rate of the focal liver lesions, liver cancer recurrence lesions after local treatment and help to differentiate focal liver lesions, to stage the malignant lesions, and it also can be more accurate quantification of liver iron, fat content, indirect measurement of hepatic blood flow dynamics change situation. ConclusionDual-energy CT scanning technology can improve the diagnostic value of CT scanning technology in liver disease.
ObjectiveTo summarize and analyze the clinical characteristics of patients with acute diffuse lung changes and respiratory failure.MethodsThe clinical data of patients in the Department of Critical Care Medicine, Dazhou Central Hospital between January 2016 and December 2018 were retrospectively collected, whose main clinical manifestation was acute respiratory distress syndrome with acute onset (<3 weeks) and main imaging manifestation was diffuse changes in both lungs. The clinical characteristics of patients were summarized, and the causes of the disease were explored.ResultsA total of 65 patients with acute diffuse lung changes and respiratory failure were enrolled, including 42 males (64.6%) and 23 females (35.4%). The average age was (57.1±18.4) years, the average time from onset to treatment was (7.5±5.9) d, and the average length of stay in the intensive care unit was (8.9±4.1) d. A total of 23 cases died, with a case-fatality rate of 35.4%. Among the 65 patients, there were 50 case (76.9%) of infectious diseases, including 36 cases of bacterial infections (including 4 cases of tuberculosis), 8 cases of viral infections (all were H1N1 infections), and 6 cases of fungal infections (including 1 case of pneumocystis infection); and there were 15 cases (23.1%) of non-infectious diseases, including 4 cases of acute left heart failure, 2 cases of interstitial pneumonia, 2 cases of vasculitis, 1 case of myositis dermatomyositis, 1 case of aspiration pneumonia, 1 case of acute pulmonary embolism, 1 case of acute drug lung injury, 1 case of neurogenic pulmonary edema, 1 case of drowning, and 1 case of unknown origin.ConclusionsInfectious diseases are the main cause of acute diffuse lung changes and respiratory failure, while among non-infectious diseases, acute heart failure and immune system diseases are common causes.
Diffuse large B-cell lymphoma is highly heterogeneous and is diagnosed according to the 2016 World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. The decision of treatment should be upon age, International Prognostic Index score and the tolerability of chemotherapy. High-dose chemotherapy and autologous stem cell transplantation is the standard care for relapsed, chemotherapy sensitive patients. Clinical trials are recommended in specific conditions.
Objective To explore the methods of evidence-based individualized treatment for a patient with Graves’ disease. Method We searched The Cochrane Library (Issue 3, 2006), SUMSEARCH (Jan.1980 to Mar. 2006), PubMed (1980 to Mar.2006), CNKI (Jan.1980 to Mar. 2006) and VIP (Jan.1980 to Mar.2006) to identify the best evidence for antithyroid drugs, iodine radioisotopes and thyroidectomy for patients with Graves’ hyperthyroidism and evaluate the quality of available evidence. Results We identified 1 clinical guideline, 1 Cochrane systematic review, 1 meta-analysis and 15 randomized controlled trials. There was no significant difference between the titration regimen and the block-replace regimen in the relapse of hyperthyroidism, while the block-replace regimen was associated with more adverse effects. Prescribing replacement thyroxine, either with or after the anti-thyroid drug treatment, had no significant effect on relapse. Methimazole was more effective than propylthiouracil in the induction of euthyroidism. There was no significant difference in the quality of life between the drugs, 131I and the thyroidectomy therapy, and the relapse was lower with thyroidectomy therapy but the cost was higher. Given the current evidence together with our clinical experience and considering the patient and her family’s values and preferences, methimazole (10 mg tid) was administered to her and then gradually reduced. No obvious adverse effects occurred within 4 months’ follow-up. Conclusion Drugs, radioactive iodine and thyroidectomy are all effective in the treatment of Graves’ hyperthyroidism. Methimazole is an effective and well tolerated drug for the treatment of Graves’ hyperthyroidism and further research into side effect are needed. Prescribing replacement thyroxine has no significant effect on relapse.
Objective To review the examination techniques and the current research progress of the magnetic resonance diffusion weighted-imaging (DWI) used in liver. Methods The recent and relevant literatures about the principles and the current study situation of liver DWI were scrutinized and analyzed retrospectively. In addition, the existing problems of liver DWI were discussed. Results DWI could demonstrate the normal and abnormal structure and function through measuring the diffusion motions of water molecule in the liver. With the improving technology and better understanding of diffusion dynamics, DWI has been used for the diagnosis and differential diagnosis for hepatic diseases. Conclusion DWI as a non-invasive examine method, may provide valuable functional information for clinical diagnosis and treatment.
Objective Methods of evidence-based medicine were used to make an individualized treatment plan concerning newly diagnosed diffuse large-B-cell lymphoma in elderly patients. Methods After clinical problems were put forward, evidence was collected from MEDLINE (Jan. 1990 to Dec. 2004) and http://sumsearch.uthscsa.edu/searchform4.htm. Subject words were: NHL; aggressive non-Hodgkin’s lymphoma; diffuse large-B-cell lymphoma; chemotherapy; CHOP; rituximab; RCT; economic evaluation; older patient. Results A total of 11 randomized controlled trials and 8 systematic reviews about chemotherapy regimen, and 1 systematic review about economic evaluation were identified. A rational treatment plan was made upon a critical evaluation of the data. After 5 months follow-up, the plan was proved optimal. Conclusions The treatment effectiveness in newly diagnosed diffuse large-B-cell lymphoma in the elderly has been improved by an individual treatment plan according to evidence-based methods.