A pilot study of lung ultrasound B-lines in diagnosis of rheumatoid arthritis associated interstitial lung diseases / 中华风湿病学杂志

Objective To assess the clinical value of lung ultrasound (LUS) B-lines in diagnosis of rheumatoid arthritis (RA) associated interstitial lung diseases (RA-ILD).Methods Forty-five consecutive patients with RA who underwent a high resolution computed tomography (HRCT) scan of the chest,were also examined by LUS for detection of B-lines(within 1 month independently in all patients).The B-lines score was obtained by summing the number of total 50 inter-costal spaces (ICSs) of chest wall.Pulmonary fibrosis was quantified by HRCT as previously described by the 30-point Warrick score.Results B-lines score significantly correlated with the Warrick score [(r=0.778,95％CI(0.627,0.872),P＜0.05].Receiver operating characteristic (ROC) curve confirmed that B-lines cut-off point 77[sensitivity of 100％,specificity of 64.3％ respectively,area under curve [AUC] =0.86,95％CI(0.724,0.945)] and 108[sensitivity of 90％,specificity of 88.6％ respectively,AUC=0.879,95％CI(0.747,0.957)] had an optimal power to discriminate mild (Warrick score＜8) and severe fibrosis (Warrick score＞15):Conclusion The data confirm that LUS is a useful technique to identify ILD in RA.In RA-ILD,B-lines correlate significantly with HRCT and are able to identify mild and severe degree of fibrosis.LUS is a promising non-invasive and non-ionizing strategy for screening RA-ILD.

Prenatal ultrasound diagnosis of fetal ear auricle abnormalities / 中华医学超声杂志（电子版）

Objective The purpose of this study was to assess the value of prenatal ultrasound diagnosis for fetal ear auricle malformations.Methods The coronal and sagittal planes of fetuses ears were obtained prospectively in 6239 singleton fetuses in the First Affiliated Hospital of Shantou University Medical College for the period from 2012 February to 2015 December,the ultrasound images and pregnancy outcomes were analyzed in 11 cases of fetuses ear auricle malformations diagnosed prenatally.Results Eleven Cases of fetuses ear auricle malformations include with 7 cases of microtia,3 cases of low-set ears and 1 case of anotia.Eleven cases were combined with other structural malformations were as followings,3cases with craniocerebral congenital malformation,5 cases with dentofacial deformity,5 cases with malformation of heart,3 cases with limb deformity.Cordocentesis was performed in 7 cases among which 6 with abnormal karyotype,including 2 cases of trisomy 21,2 cases of trisomy 13,2 cases of trisomy 18,1 case of 22ql 1 abnormalities.Compared with the postpartum facial examination,prenatal ultrasound correctly diagnosed 10 cases of fetal ear auricle malformations,missed diagnosis 1 case of microtia.Conlusions Fetus with ear auricle abnormalities have characteristic prenatal ultrasound imaging;prenatal ultrasonography can provide reliable information in the diagnosis of this disease.This study suggests that antenatal ear auricle length measurements might be a promising sonographic screening method for the detection of abnormal karyotype in pregnancy.

Clinical application of interventional treatment for uterine scar pregnancy by vaginal color Doppler ultrasound guidance / 中国基层医药

Objective To investigate the efficiency of interventional treatment and intramuscular injection of methotrexate for the treatment uterine scar pregnancy.Methods 22 patients with uterine scar pregnancy were divided into two groups,group A (n =12),transvaginal color Doppler ultrasound to guide percutaneous interventional treatment;group B( n =10) intramuscular injection of methotrexate treatment.Mass size and β-HCG preoperation and 4 days,7 days,1 month postoperation were evalutaed respectively.Results The cure rate of interventional treatment and intramuscular injection of methotrexate for the treatment uterine scar pregnancy were 83.3％ and 40.0％ respectively.And the difference was statistically significant ( P ＜ 0.05 ).Conclusion Compared with intramuscular methotrexate treatment of uterine scar pregnancy,guided by vaginal ultrasonography involved the injection of methotrexate is more effective and have important clinical significance.

Intersphincteric resection for ultra-lower rectal tumor / 中华普通外科杂志

Objective To summarize the clinical experience of interspineter resection in treating ultra-lower rectal tumor. Methods Twenty-six ultra-lower rectal tumor cases (24 cases of rectal cancer, 2 cases of giant villous adenoma) without extrasphincter involvement underwent total mesoreetal excision and interspineter resection. Partial, subtotal or total innerspineter resection was performed respectively for patients in which the tumor lower margin was over 2 cm, between 1 -2 cm, and less than 1.0 cm above thedentate line respectively. Alimentary tract continuity was constructed by end to end anastomsis of the colon and anus. Results The lower margin of tumor in 26 patients was within 0 - 3 cm above the dentate line.The pathology was highly differentiated in 6 cases and medium differentiated in 16 cases, papillary carcinoma in 2 cases, giant villous adenoma in 2 cases. There were 11 cases of stage Ⅰ , 8 of stage Ⅱ A, 4 of stage Ⅲ A, and 1 of stage Ⅲ B according to pTNM system; 8 cases of T1, 15 of T2, and 1 of T3 according to T stage criteria. There was no mortality nor major complications. Two cases suffered from anastomotic stricture. The stool seepage was common at early stage after surgery, with immediately postoperative daily defecation of 3 -10, and one year later, most patients were able to hold back the defecation impulse for more than 5 min, and have daily defecation of 0. 5 to 4 times. Occasional seepage was reported in one patient with total innersphincter resection. The average postoperative follow up was 28 months. One recurrence was found on the 5th month, one suffered from liver metastasis in the 10 month, and one died of cardiac arrest in 26 month. Conclusion To those patients with very lower rectal cancer restricted within rectal wall,interspincter resection fulfils curative purpose while preserving the anal function.

Combined posterior excision of anus and modified Block’s repair for the treatment of constipation of anterior rectocele / 中国普通外科杂志

Objective To evaluate combined posterior excision of anus and modified Block′s repair for the treatment of constipation of anterior rectocele. MethodsClinical data of 82 patients treated by combined posterior resection of anus and modified Block′s technique in our hospital between Oct 2002 and May 2004 were retrospectively analyzed.ResultsThe overall effective rate was 96%, cure rate of 67%, significant improvement of 18%, and improvement of 11%. The mean hospital stay was 18.8?4.8 days, and no postoperative complication. Follow-up from 1 to 4 years found no recurrence of constipation and loss of control of evacuation.Conclusions This procedure is effective for the treatment of constipation of anterior rectocele type, and it prevents stricture of anus in patients with a relative narrow lumen of the anus.