Search

The incidence of pancreatic cancer is increasing worldwide. Approximately, 60 of patients with pancreatic cancer have distant metastases at the time of diagnosis, of which only 10 can be removed using standard resection. Further, patients derive limited benefits from chemotherapy or radiotherapy. As such, alternative methods to achieve local control have emerged, including permanent iodine-125 seed interstitial brachytherapy. In 2023, the Chinese College of Interventionalists, affiliated with the Chinese Medical Doctor Association, organized a group of multi-disciplinary experts to compose guidelines for this treatment modality. The aim of this conference was to standardize the procedure for permanent iodine-125 seed interstitial brachytherapy, including indications, contraindications, pre-procedural preparation, procedural operations, complications, efficacy evaluation, and follow-up. Keywords: Brachytherapy, guideline, iodine-125, pancreatic cancer, Author(s): Bin Liu [1,2]; Wei Huang [3]; Fujun Zhang [4]; Junjie Wang [5]; Jinhe Guo [6]; Xuequan Huang [7]; Guangyan Lei [8]; Juan Wang [9]; Xin Ye [10]; Ruoyu Wang [...]

ABSTRACT Purpose: To investigate the effects of iodine-125 seed brachytherapy (ISB) on the overall survival (OS) of patients with heterochronous pulmonary metastasis (HPM) secondary to hepatocellular carcinoma (HCC). Materials and Methods: The clinical and imaging data of 123 patients with HPM secondary to HCC treated at a single center from July 2012 to July 2020 were analyzed retrospectively. The patients were divided into ISB and non-ISB groups based on ISB treatment. Propensity score matching yielded 46 pairs of patients. A total of 191 lesions were treated, and the data were evaluated for 6 months after ISB. The OS rates of the two groups were compared using the Kaplan-Meier method. Independent prognostic factors were determined using a Cox proportional hazards regression model. Results: The percentages of lung lesions in complete remission, partial remission, disease stable, and disease progression stages were 49.2, 32.8, 9.6, and 8.4, respectively. The disease control rate was 91.6. The median follow-up time from the initial diagnosis was 47 months and 33 months for the ISB and non-ISB groups, respectively. Patients in the ISB group had a longer OS than those in the non-ISB group (1-year: 95.7 vs. 80.3; 3-year: 62.9 vs. 45.7; 5-year: 37 vs. 20.9; P < 0.05). Multivariate analysis demonstrated that ISB treatment, tumor differentiation, vascular invasion, and Child - Pugh score were independent prognostic factors for survival. Conclusion: ISB improves local control and OS rates of HPM secondary to HCC; thus, it is an effective and feasible option for patients with HPM secondary to HCC. Keywords: Hepatocellular carcinoma, iodine-125 seeds, prognostic factors, propensity score matching, pulmonary metastasis, Author(s): Chongshuang Yang [1,2]; Chuang He [2]; Songtao Yu [3]; Jing Yuan [4]; Yunhua Xiao [2]; Xuequan Huang (corresponding author) [2] INTRODUCTION Hepatocellular carcinoma (HCC) is one of the most [...]

Byline: Yingtian. Wei, Yueyong. Xiao, Zhongmin. Wang, Xiaokun. Hu, Guang. Chen, Xiaoyi. Ding, Yong. Fan, Yue. Han, Kaiwen. Huang, Xuequan. Huang, Ming. Kuang, Xu. Lang, Hailiang. Li, Chengli. Li, Jiakai. [...]

Byline: Fujun. Zhang, Junjie. Wang, Jinhe. Guo, Xuequan. Huang, Zhiyu. Guan, Guangyan. Lei, Juan. Wang, Xin. Ye, Xiaogang. Zhao, Jing. Wang, Ruoyu. Wang, Bin. Liu, Qing. Zhou, Mingfang. Zhao, Chuanxin. [...]

The lung is the primary organ targeted by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), making respiratory failure a leading coronavirus disease 2019 (COVID-19)-related mortality. However, our cellular and molecular understanding of how SARS-CoV-2 infection drives lung pathology is limited. Here we constructed multi-omics and single-nucleus transcriptomic atlases of the lungs of patients with COVID-19, which integrate histological, transcriptomic and proteomic analyses. Our work reveals the molecular basis of pathological hallmarks associated with SARS-CoV-2 infection in different lung and infiltrating immune cell populations. We report molecular fingerprints of hyperinflammation, alveolar epithelial cell exhaustion, vascular changes and fibrosis, and identify parenchymal lung senescence as a molecular state of COVID-19 pathology. Moreover, our data suggest that FOXO3A suppression is a potential mechanism underlying the fibroblast-to-myofibroblast transition associated with COVID-19 pulmonary fibrosis. Our work depicts a comprehensive cellular and molecular atlas of the lungs of patients with COVID-19 and provides insights into SARS-CoV-2-related pulmonary injury, facilitating the identification of biomarkers and development of symptomatic treatments.

Systematic autopsy and comprehensive pathological analyses of COVID-19 decedents should provide insights into the disease characteristics and facilitate the development of novel therapeutics. In this study, we report the autopsy findings from the lungs and lymphatic organs of 12 COVID-19 decedents—findings that evaluated histopathological changes, immune cell signature and inflammatory factor expression in the lungs, spleen and lymph nodes. Here we show that the major pulmonary alterations included diffuse alveolar damage, interstitial fibrosis and exudative inflammation featured with extensive serous and fibrin exudates, macrophage infiltration and abundant production of inflammatory factors (IL-6, IP-10, TNFα and IL-1β). The spleen and hilar lymph nodes contained lesions with tissue structure disruption and immune cell dysregulation, including lymphopenia and macrophage accumulation. These findings provide pathological evidence that links injuries of the lungs and lymphatic organs with the fatal systematic respiratory and immune malfunction in critically ill COVID-19 patients.

The goal of this study was to investigate the effect of individualized chemotherapy delivered via percutaneous catheter drainage on paravertebral abscesses in spinal tuberculosis (TB). Data from 48 patients with spinal TB with paravertebral abscesses who received individualized chemotherapy via computed tomography–guided catheterization between 2009 and 2012 were retrospectively analyzed. The paravertebral abscesses affected the thoracic vertebra (n=12), the lumbar spine (n=20), the thoracolumbar vertebra (n=10), and the lumbosacral (n=6). All patients achieved clinical healing with no recurrence. Erythrocyte sedimentation rate and visual analog scale scores decreased significantly by the endpoint of follow-up. Although C-reactive protein values increased slightly right after treatment, they were also significantly lower at last follow-up. The kyphotic angle and Oswestry Disability Index values also exhibited significant decreases. No neurologic function impairment was reported. Computed tomography–guided catheterization for continuous administration of individualized chemotherapy was a safe and effective treatment for spinal TB with paravertebral abscesses in the cohort examined, and thus, it warrants further study. [The goal of this study was to investigate the effect of individualized chemotherapy delivered via percutaneous catheter drainage on paravertebral abscesses in spinal tuberculosis (TB). Data from 48 patients with spinal TB with paravertebral abscesses who received individualized chemotherapy via computed tomography–guided catheterization between 2009 and 2012 were retrospectively analyzed. The paravertebral abscesses affected the thoracic vertebra (n=12), the lumbar spine (n=20), the thoracolumbar vertebra (n=10), and the lumbosacral (n=6). All patients achieved clinical healing with no recurrence. Erythrocyte sedimentation rate and visual analog scale scores decreased significantly by the endpoint of follow-up. Although C-reactive protein values increased slightly right after treatment, they were also significantly lower at last follow-up. The kyphotic angle and Oswestry Disability Index values also exhibited significant decreases. No neurologic function impairment was reported. Computed tomography–guided catheterization for continuous administration of individualized chemotherapy was a safe and effective treatment for spinal TB with paravertebral abscesses in the cohort examined, and thus, it warrants further study. [Orthopedics.2017; 40(3):e443–e449.]

Purpose To highlight the computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of lacrimal gland adenoid cystic carcinoma.Methods We reviewed the clinical records and imaging findings of 17 patients who were histopathologically diagnosed with primary adenoid cystic carcinoma of the lacrimal gland between August 1998 and November 2010. Orbital CT scans were performed in 17 patients and MRI scans were obtained in 13 patients.Results On the CT scans, out of 4 cases of adenoid cystic carcinoma, 3 showed characteristic features of a soft tissue mass with poorly enhancing areas representing cystic changes, and 4 of 17 cases had contiguous bony erosion. On the MRI scans, all cases had mixed signal intensity on T2-weighted images, and 6 cases showed poorly enhancing areas.Conclusions Enhanced CT and MRI (including T2-weighted) are helpful in the diagnosis of primary adenoid cystic carcinoma of the lacrimal gland.

ObjectiveAmyotrophic lateral sclerosis (ALS) is an idiopathic and fatal neurodegenerative disease of the human motor system. While microstructural alterations in corpus callosum (CC) have been identified as a consistent feature of ALS, studies directly examining interhemispheric neural connectivity are still lacking. To shed more light on the pathophysiology of ALS, the present study aims to examine alterations of interhemispheric structural and functional connectivity in individuals with ALS.MethodsDiffusion tensor imaging (DTI) and resting-state functional MRI (rfMRI) data were acquired from 38 individuals with ALS and 35 gender-matched and age-matched control subjects. Indices of interhemispheric functional and structural neural connection were derived with analyses of voxel mirrored homotopic connectivity (VMHC) and probabilistic fibre tracking.ResultsThe rfMRI has revealed extensive reductions of VMHC associated with ALS in brain regions of the precentral and postcentral gyrus, the paracentral lobule, the superior temporal gyrus, the middle cingulate gyrus, the putamen and the superior parietal lobules. With DTI, the analysis has also revealed reductions of interhemispheric structural connectivity through the CC subregions II, III and V in patients with ALS. Additionally, interhemispheric functional connectivity of the bilateral precentral gyri positively correlated with fractional anisotropy values of the CC subregion III, which structurally connects the bilateral motor cortices.ConclusionsThe present data provided direct evidence confirming and extending the view of impaired interhemispheric neural communications mediated by CC, providing a new perspective for examinations and understanding the pathophysiology of ALS.

Byline: Qingchun. Li, Yun. Liang, Ye. Zhao, Baodong. Gai Owing to the location of the pancreas and its complex anatomical relationship, it is difficult to perform radioactive Iodine-125 seed implantation [...]