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Objective:To evaluate the clinical application efficacy of four-stitch cholangiojejunostomy.Methods:Of 38 patients who received four-needle biliary and enterointestinal anastomosis in the Department of Hepatobiliary Surgery, Yuebei People's Hospital Affiliated to Shantou University Medical College from November 2016 to April 2020 were included, and the diseases, surgical methods and postoperative complications of four-needle biliary and enterointestinal anastomosis were analyzed.Results:There were 26 males and 12 females with an average of 57.3(44-77) years. Among 38 patients, there were 12 hilar cholangiocarcinoma patients, 10 pancreatic head cancer, 9 duodenal papillary cancer, 4 intrahepatic and extrahepatic bile duct stones, 1 pancreatic cystic adenoma, 1 gastric cancer invading pancreatic head and 1 gallbladder carcinoma. The procedure included pancreatoduodenectomy in 20, radical resection of hilar cholangiocarcinoma in 12, hepatectomy with biliary-enteric anastomosis in 4, radical resection of gastric cancer combined with pancreaticoduodenectomy in 1, radical resection of gallbladder carcinoma in 1. One, two and three ductal openings were anastomosed in 27, 7 and 4 patients, respectively. 10 patients have bile duct diameter <6 mm. Postoperative anastomotic leakage occurred in 1, and all patients were received followed-up visit for 2 months to 4 years without anastomotic stenosis.Conclusion:Four-stitch cholangiojejunostomy is simple, safe, effective, and convenient for small biliary ductal surgeries.
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Objective:To investigate the effect of cluster protection measures on postoperative infection in elderly lumbar disc herniation patients undergoing minimally invasive surgery by using intervertebral foramen mirror surgery.Methods:A total of 98 elderly lumbar disc herniation patients treated with the surgery in our hospital were enrolled from January 2018 to December 2019.They were randomized into the intervention group(n=49)receiving cluster protection measures and the routine group(n=49)receiving conventional protection measures.The incidences of infection and related indexes after surgery were compared between the two groups.Results:A total infection rate was higher in the routine group [16.33%(8/49)]than in the intervention group [4.08%(2/49)]( χ2=4.009, P=0.045). The operation time, out-of-bed activity time, hospitalization days and surgical blood loss were less in the intervention group than in the routine group[(30.4±1.1) min vs.(101.9±51.1) min, (1.6±0.7) d vs.(3.7±1.2) d, (4.3±0.6) d vs.(13.2±3.8) d, (54.8±7.3) ml vs.(142.7±69.6) ml, t=9.759, 10.193, 15.789 and 8.780, all P=0.000]. Conclusions:Compared with the routine prevention measures, the cluster prevention measures can ensure the perioperative safety, shorten the operation time and reduce surgical blood loss, out-of-bed activity time and hospitalization days.Therefore, after careful perioperative treatment and protection, the cluster prevention measures can relieve pain, restore function, reduce the incidences of postoperative infection and complications, and achieve satisfactory nursing results.
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Objective@#To examine the Quality of life among school-aged children with dyslexia in target city and to provide scientific evidence for improving the quality of life of children with dyslexia.@*Methods@#By using cluster sampling,students from grade 3 to grade 6 from 6 primary schools in a middle-sized were selected and administered with questionnaire survey. According to the criteria of dyslexia, dyslexic children and non-dyslexic children were identified and the difference of the Quality of Life was compared.@*Results@#Totally 3 673 children were collected, and 119 of them were identified as dyslexia(3.24%).The prevalence of dyslexia differed by gender,grades,educational level of parents(χ2=24.77,11.75,18.50,9.79,P<0.05). The Quality of Life which below the average proportion accounted for 30.3% of dyslexic children and 16.7% of normal children. Quality of life scored signiticantly different between dyslexic children and non-dyslexia children, including psychosocial functioning domain(134.54±30.88)(143.49±32.53), physical and mental health domain(2.71±0.84)(2.92±0.81) vs (2.83±0.90)(3.06±0.87), the living satisfaction domain(2.95±0.87)(3.14±0.87)(t=-6.09，-5.48，-5.44，-4.50，P<0.01),with dyslexic group significantly lower than that of non-dyslexic group.@*Conclusion@#The Quality of Life of Dyslexic children was in a poor condition.
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Objective To evaluate the clinical efficacy of autologous whole blood injections (AWBI) combined with antihistamines for the treatment of patients with refractory chronic spontaneous urticaria and positive autologous serum skin test (ASST),to evaluate its effect on the expression of the high-affinity IgE receptor (FcεR Ⅰ) and CD63 on basophils,and to analyze the possible mechanism underlying the treatment of ASST-positive chronic urticaria with AWBI.Methods Eighty patients with ASST-positive chronic intractable urticaria were enrolled from Department of Dermatology,The First Hospital Affiliated to Army Medical University between November 2017 and June 2018,and randomly and equally divided into two groups by a random number table:AWBI group and control group were both conventionally treated with oral loratadine and ebastine,and AWBI group were additionally treated with AWBI once a week for 12 sessions.Before the treatment and after 12-week treatment,urticaria activity score of 7 days (UAS7) and dermatology life quality index (DLQI) in the two groups were evaluated.Among 30 patients in the AWBI group,flow cytometry was performed to determine the expression of FcεRⅠ and CD63 on the basophils in the peripheral blood at the baseline,weeks 4,8 and 12 after the initial treatment.Statistical analysis was carried out with GraphPad Prism 7.00 software by t test for the comparison of UAS7 or DLQI scores,Mann-Whitney U test for the comparison of FcεR Ⅰ α expression,paired Wilcoxon signed rank test for comparing FceR Ⅰ α or CD63 expression between two different time points,and Spearman correlation analysis for analyzing the correlation between FcεR Ⅰ α and CD63 expression.Results Before the treatment,no significant differences in UAS7 or DLQI scores were observed between the AWBI group and control group (UAS7:27.15 ± 4.53 vs.26.90 ± 5.22;DLQI:16.88 ± 6.01 vs.17.08 ± 6.79;both P ＞ 0.05).After 12-week treatment,UAS7 and DLQI scores both significantly decreased in the two groups compared with those before the treatment (all P ＜ 0.01),and were significantly lower in the AWBI group than in the control group (UAS7:14.25 ± 7.56 vs.19.93 ± 6.32;DLQI:8.48 ± 4.15 vs.13.93 ± 5.43;both P ＜ 0.01).At the baseline,weeks 4,8 and 12 after the initial treatment,the fluorescence intensities of FcεR Ⅰα on basophils (M [P25,P75]) in the AWBI group were 22 532 (16 740,29 220),16 911 (10 240,21 816),13 282 (7 600,16 848) and 11 466 (7 161,14 578) respectively,and the proportions of CD63+ basophils induced by ASST-positive serum (M [P25,P75]) in the AWBI group were 35.25％ (26.75％,49.13％),25.95％ (19.37％,37.54％),13.57％ (7.79％,19.57％) and 9.87％ (6.43％,16.52％) respectively.At week 4 after the initial treatment,the expression of FcεR Ⅰα and CD63 on basophils in the AWBI group both significantly decreased compared with those at the baseline (both P ＜ 0.01),but significantly increased compared with those at week 8 (both P ＜ 0.01).The changes in FcεR Ⅰ α expression from baseline to week 4,from week 4 to week 8,and from week 8 to week 12 were positively correlated with the changes in CD63 expression induced by ASST-positive serum (r =0.364,0.422,0.455,respectively,all P ＜ 0.05).Conclusion AWBI combined with antihistamines can improve the clinical symptoms of ASST-positive refractory chronic urticaria,likely by affecting the expression of FcεR Ⅰ and CD63 on basophils.
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Objective To study the enhanced performance of contrast-enhanced ultrasouond( CEUS) parametric imaging , and to explore the diagnostic value of CEUS parametric imaging in predicting extracapsular invasion and cervical lymph node metastasis of papillary thyroid cancer( PTC) . Methods One hundred and fifty-eight PTCs in 136 patients pathologically proven papillary thyroid carcinoma between January 2016 and January 2017 were enrolled in this study . According to the pathological results of extracapsular invasion and cervical lymph node metastasis respectively ,the PTCs were grouped into the negative group and the positive group . The parametric imaging features of the two groups were summarized to explore the risk factors of extracapsular invasion and cervical lymph node metastasis of PTCs respectively . Results The parametric imaging suggested that centripetal enhancement had a significant effect on extracapsular invasion ( P =0 .001) . While there was no difference in the perfusion start time of extracapsular invasion between the negative and positive group ( P > 0 .05 ) . Besides , there was no statistical significance in the perfusion start time and perfusion pattern of cervical lymph node metastasis between the negative and positive group (all P >0 .05) .Conclusions The parametric imaging features help predicting extracapsular invasion in PTCs . And the ones with centripetal enhancement patterns are more often with extracapsular invasion .
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Objective To explore the relationship among thyroid stimulating hormone level and sex hormone level,blood lipid level and insulin resistance in patients with polycystic ovary syndrome. Methods From February 2014 to February 2017,eighty cases with polycystic ovary treated in the People's Hospital of Longhua,Shenzhen were selected as the research object. The clinical data of all patients were collected to check the indexes of thyroid function,lipid metabolism,glucose metabolism,and sex hormone related indexes,and the insulin resistance index (HOMA-IR) was calculated according to the related indexes of glucose metabolism. The patients were divided into group according to the level of thyrotropin,group A (thyrotropin＜2. 5mIU / L),group B (2. 5mIU / L＜thyrotropin＜4. 0mIU / L) and group C (thyrotropin＞4. 0mIU / L). According to the patient's insulin resistance index,the patients were divided into IR group and non IR group. According to the blood lipid metabolism index,the patients were divided into abnormal blood lipid group and non lipid abnormality group. The levels of thyrotropin and sex hormone related indexes were compared in different groups, and the correlation between thyrotropin level and various indexes was analyzed. Results The differences in body mass index ((23. 3±4. 2) kg/m2vs. (23. 8±3. 5) kg/m2vs. (25. 6±5. 2) kg/m2),luteinizing hormone((11. 9±1. 1)U/L vs. (11. 7±1. 2)U/L vs. (9. 5±1. 0)U/L),low density lipoprotein cholesterol ((2. 4±0. 9) mmol/L vs. (2. 7 ±0. 7) mmol/L vs. (2. 9±0. 8) mmol/L),high-density lipoprotein cholesterol ((1. 5±0. 4) mmol/L vs. (1. 5 ±0. 5) mmol/L vs. (1. 3±0. 2) mmol/L),triglyceride ((1. 1±0. 8) mmol/L vs. (1. 5±0. 9) mmol/L vs. (1. 8 ±0. 7) mmol/L),and apolipoprotein A ((1. 8±0. 5) mg/L vs. (1. 7±0. 4) mg/L vs. (1. 5±0. 3) mg/L) among group A,B and C were statistically significant (F＝8. 456,9. 587,11. 245,10. 784,10. 847,10. 214,P＜0. 05). The serum TSH concentration in group IR was significantly higher than that in non IR group (( 3. 1 ±1.1) mU/L vs.(2.3±0.8) mU/L) (t＝3.551,P＜0.05).The serum LH concentration in group IR was significantly lower than that in non IR group((9. 4±1. 1)U/L vs. (11. 2±2. 1)U/L) (t＝3. 739,P＜0. 05). The level of TSH in dyslipidemia group was significantly higher than that of non dyslipidemia group(( 3. 2 ± 1. 3) mU/L vs. (2. 4±1. 1) mU/L) (t＝3. 551,P＜0. 05),and the level of LH in dyslipidemia group was significantly lower than that of non dyslipidemia group((9. 3±1. 6)U/L vs. (11. 6±2. 4)U/L) (t＝4. 709,P＜0. 05). The TSH level in patients with polycystic ovary syndrome was positively correlated with body mass index, three acylglycerol,low density lipoprotein cholesterol and insulin resistance index( r＝0. 272,0. 317,0. 364,0. 227) ( P＝0. 015,0. 004,0. 003,0. 043),and there was a negative correlation with luteinizing hormone and high-density lipoprotein cholesterol(r＝－0.616,-0.254) (P＝0.000,0.034).Conclusion Hyperthyroidism in patients with polycystic ovary syndrome is associated with abnormal blood lipid,abnormal sex hormone levels,and insulin resistance.
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Objective To compare the effects of 3D laparoscopic hepatectomy (3D-LH) and open hepatectomy(OH)in glissonian access for hepatocellular carcinoma(HCC)on postoperative immunosuppression by analyzing cellular immune function. Methods During January 2014 to December 2017,sixty patients randomly scheduled to undergo hepatectomy were divided into 3D-LH group and OH group,with 30 patients in each group. All patients' peripheral blood was sampled to measure cell-mediated-immunologic markers(CD4+,CD8+T cell) before operation and in the mornings of the 1st,7thday after surgery. The effects of different operative methods on cellular immune function in patients organism were investigated. Results The decreased level in 3D-LH group was less than that in OH group in postoperative 1stday. The improvement in the 3D-LH group was more faster than that in the OH group on postoperative 7thday. There was statistical significance between the two groups(P<0.05), respectively. Conclusion When compared to open hepatectomy ,3D laparoscopy liver resection in glissonian approach for HCC,less effects in cellular immune function.
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Objective To explore the diagnostic value of conventional ultrasound(US) and contrast enhanced ultrasound(CEUS) in predicting extrathyroidal extension of papillary thyroid cancer(PTC).Methods Eighty-five PTCs in 75 patients were selected for thyroid surgery underwent ultrasound and contrast-enhanced ultrasound.The degrees of contact between PTCs and capsule were observed by US and CEUS respectively(0,0-25％,25％-50％,≥50％),and the diagnostic efficiency in different degree of contact (＞0 ％,≥25 ％,≥50％) as preoperative diagnostic criteria were analyzed.The diagnostic efficiency between US and CEUS in predicting extrathyroidal extension of PTC were compared.Results Of the 85 PTCs,extrathyroidal extension was presented in 57 (67.06％) based on pathologic results.When the degree of contact (＞ 0 ％,＜ 25 ％,25 ％-50 ％,≥ 50 ％) was gradually increased,the incidence of extrathyroidal extension of the thyroid cancer was also gradually risen (P ＜0.001).Comparing the sensitivity,accuracy,odds ratio,and Az value of three groups(＞0％,≥25％,≥50％),it showed that the general diagnostic efficiency between two groups(＞0％,≥25％) was similar by US and CEUS.However,the sensitivity and accuracy of ＞0％ contact with the adjacent capsule were markedly higher than those of the other two groups(P ＜0.001).Selecting ＞0％ contact with the adjacent capsule as preoperative criteria,the Az value of CEUS was markedly higher than that of US (Z =2.208,P =0.027).Conclusions The preoperative imaging feature of more than 0％ contact with the adjacent capsule is more sensitive and accurate degree in predicting extrathyroidal extension of PTC.Compared with US,CEUS may serve as a better useful tool to predict extrathyroidal extension of PTC.
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Objective To explore the clinical value of laparoscopy combined with choledochoscopy in repeat surgery for hepatolithiasis. Methods The clinical data on 86 patients who had undergone repeat surgery for hepatolithiasis during January 2010 to December 2015 were retrospectively analyzed. 36 patients received laparoscopy combined with choledochoscopy(laparoscopy group),while 50 patients received laparotomy(laparotomy group). Surgical duration,intraoperative blood loss,intraoperative transfusion,stone clearance rates,length of postopera-tive hospital stay,and rate of complications were observed and analyzed. Results There were no significant differ-ences in surgical duration,intraoperative blood loss,intraoperative transfusion,stone clearance rates,and rate of complications between the two groups(P>0.05). Length of postoperative hospital stay was significantly shorter in the laparoscopy group than in the laparotomy group(P 0.05). Conclusions Use of laparoscopy combined with choledochoscopy in repeat surgery for hepatolithiasis is safe and feasible and has a satisfactory efficacy.
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Congenital diaphragmatic hernia(CDH) is one of the critical congenital malformations disease which caused the defects of the diaphragmatic hernia,the hernia of the abdominal viscera into the thoracic cavity and the dysplasia of the lung because of the abnormal development of the embryo.The degree of pulmonary hypoplasia determined the curative effect of surgical treatment,so it is a key problem to improve the condition of pulmonary hypoplasia in treatment of CDH.Now it is feasible to make early prenatal diagnosis,predict outcomes and select the best operative opportunity of CDH with ultrasonography.It is a trend to treat CDH with endoscopic surgery of the minimally invasive operation.This article focuses on the latest diagnostics,treatment and new research progress of CDH,and summarized as follows.
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Objective:To evaluate the immunomodulating effect of oyster peptide on immunosup-pressed mice.Methods:ICR mice injected with cyclophosphamide (CTX)were adopted as the module group,with mice without treatment as the control group,and different dosages of oyster peptide (0.5 g/kg,1 .0 g/kg,and 2.0 g/kg)were given to the low,middle,and high groups for 1 5 days.The body weight,spleen,and thymus weight of the mice,structures under the microscope of the immune organs, numbers of white blood cells,ratios of T lymphocyte subsets,immune cytokines and numbers of nuclear cells,and DNA content in bone marrow were all assessed.Results:Compared with the control group, the structures of thymus and spleen of the mice in the CTX group appeared obscure and shrunk when ob-served under microscope,the number of their white blood cells declined (P =0.04),the proportion of their CD3 +T cells in peripheral blood declined (P =0.003),the proportion of their CD8 +T cells in pe-ripheral blood declined (P =0.002),the concentration of their IL-5 in peripheral blood significantly in-creased (P <0.01 ),the concentration of their nucleated cells and DNA density in bone marrow de-creased (P =0.04,P <0.01 ).Oyster could improve the structures of thymus and spleen of the immuno-suppressed mice.Compared with the CTX group,the number of white blood cells in 2.0 g/kg group in-creased (P =0.003),the proportion of CD3 +T cells in peripheral blood in 1 .0 g/kg group (P =0.04) and 2.0 g/kg group (P =0.02)increased,the proportion of CD8 +T cells in peripheral blood in 2.0 g/kg group increased (P =0.002),the concentration of IL-5 in peripheral blood in all the oyster treated groups increased (P <0.01 in 0.5 g/kg,1 .0 g/kg,and 2.0 g/kg groups),the concentration of IL-1 7 in peripheral blood in 2.0 g/kg group decreased (P =0.03),the concentration of nucleated cells in bone marrow of all the oyster treated groups increased (0.5 g/kg vs.CTX,P =0.04;1 .0 g/kg vs. CTX,P =0.02;2.0 g/kg vs.CTX P =0.01 ),the DNA content in bone marrow of all the oyster treated groups increased (P <0.01 in the 0.5 g/kg,1 .0 g/kg,and 2.0 g/kg groups).Conclusion:Oyster peptide could improve the structures of immune organs of the CTX-induced immunosuppressed mice,re-cover the imbalances of T lymphocyte subsets,improve the immune cytokines and increase numbers of nucleated cells and DNA content in bone marrow,thus improving the immunologic function.
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Objective To study the enhanced patterns of papillary thyroid carcinoma (PTC)on contrast-enhanced ultrasound(CEUS),and explore the relationship between the degree of enhancement and extracapsular invasionand cervical lymph node metastasis of the tumor.Methods Seventy-three PTCs in 61 patients selected for thyroid surgery underwent conventional ultrasound andcontrast-enhanced ultrasound. The enhanced patterns were analyzed.The differences between different degree enhancement and extracapsular invasion and cervical lymph node metastasis of PTCs were compared.Results Seventy-three PTCs enhanced patterns showed that 52(71 .2%)nodules with hypoenhancement,13(1 7.8%)nodules with isoenhancement,8 (1 1 .0%)nodules with hyperenhancement.Twenty-three (44.2%,23/52 )nodules with extracapsular invasion in hypoenhancing patterns,and 1 5 (71 .4%,1 5/21 ) nodules with extracapsular invasion in isoenhancing or hyperenhancing patterns.There were significant differences between them(P 0.05 ).Conclusions The degree of enhancement are correlate to invasiveness in PTCs,PTCs with isoenhancement or hyperenhancement patterns were more often with extracapsular invasion.
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Objective To explore the feasibility for the tissue dispersion quantitative analysis software of ultrasonic strain elastography in diagnosing benign or malignant of thyroid lesions.Methods Eighty-two patients with 98 lesions were examined by ultrasonic strain elastography.There were 11 parameters of elastography imaging obtained by the tissue dispersion quantitative analysis software,including average relative strain value(MEAN),standard deviation of relative strain value(SD),area ratio of low-strain region (AREA％),complexity(COMP),kurtosis(KURT),skewness (SKEW),contrast (CONT),entropy(ENT),inverse different moment (IDM),angular second moment (ASM),correlation (CORR).The receiver operating characteristic (ROC) curve was constructed if there were statistically significant differences between benign and malignant lesions,and the areas under the ROC curve were got.Results All parameters except CORR had statistically significant between the groups of benign and malignant thyroid lesions (P ＜0.05).The AREA％ and IDM were the best valuable parameters,the areas under the curve(AUC) of which were 0.965 and 0.908,respectively.Their cut-off point were 81.96％ and 0.42,the sensitivity and specificitywere 98.4％ and 89.2％,91.8％ and 86.5％,respectively.Conclusions The tissue dispersion quantitative analysis software is helpful in the evaluation of benign ormalignant of thyroid lesions,parameters of AREA％ and IDM has the highest relationship with pathology and good diagnostic value.
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<p><b>OBJECTIVE</b>To study the value of rigid choledochoscope and pneumatic lithotripsy in targeting treatment of hepatolithiasis under the guidance of three-dimensional visualization technology.</p><p><b>METHODS</b>The 26 patients with hepatolithiasis from February 2012 to June 2013 were analyzed. There were 11 male and 15 female patients with a median age of 55.2 years (range 31-75 years old). The image data of CT scanning of hepatolithiasis were introduced into medical image three-dimensional visualization system (MI-3DVS) for three-dimensional reconstruction, 3D classifications of hepatolithiasis were obtained based on it. Applied rigid choledochoscope and pneumatic lithotripsy in targeting treatment of hepatolithiasis guided by three-dimensional visualization technology.</p><p><b>RESULTS</b>The 26 patients (29 times) experienced targeting treatment of rigid choledochoscope and pneumatic lithotripsy under the guidance of three-dimensional visualization technology, including:19 cases (4 cases of type IIc) through percutaneous biliary tract sinus, laparoscopic surgery 3 cases, laparotomy 4 cases. Three patients underwent surgery twice. The final stone clearance rate was 100%.One case confirmed combined with cholangiocarcinoma and transfer to radical resection.Intraoperative blood loss was (41.7 ± 8.5) ml, operating time was (100.8 ± 7.6) minutes, and postoperative hospital stay was (7.0 ± 0.6) days. A patient suffered postoperative biliary tract bleeding.Without bile duct injury, bleeding, bile leakage and other complications were occurred.</p><p><b>CONCLUSION</b>Rigid choledochoscope and pneumatic lithotripsy in the treatment of hepatolithiasis under the guidance of three-dimensional visualization technology achieved digital minimally invasive treatment of hepatolithiasis, which can be a new approach to hepatobiliary surgery.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Bile Ducts, Intrahepatic , General Surgery , Cholelithiasis , General Surgery , Endoscopes , Endoscopy , Imaging, Three-Dimensional , Lithotripsy , Methods , Treatment OutcomeABSTRACT
Digital medical technology pioneered the three dimensional (3D) era of the surgery.The 3D reconstruction and visualization technology made a breakthrough of the bottleneck of clinical diagnosis and therapy of the biliary surgery,and are widely used for the treatment of biliary disease such as hepatolithiasis and hilar cholangiocarcinoma,and achieved digital anatomy,procedural diagnosis and visualized surgery,just as provide a 3D Ⅹ-ray vision to surgeons.With the development of the digital medical technology and the wide application of 3D laparoscopy and robotic system,biliary tract surgery access to a 3D era.
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Objective To analyze the findings of recurrent/residual caner after thyroidectomy for thyroid cancer in both ultrasonography (US) and contrast-enhanced CT (CECT),and to assess the diagnostic value of combination of these two modalities.Methods Forty-six patients with recurrence/ residue of thyroid cancer underwent both high-frequency US and CECT examinations and were enrolled in this study.The imaging features on US and CECT were reviewed and diagnostic accuracies for local residual lesions and cervical lymph node metastasis were evaluated according to pathological results.Results In 46 patients,the average period between thyroidectomy and diagnosis of recurrent/residual cancer was (14.6 ± 12.1) months(range,7 days-10 years).Twenty patients had local recurrent tumors at the surgical bed and the average size of tumors was 2.1 cm(range,0.5-4.6 cm).On US finding,the recurrent/residual tumors were hypoechoic in 60 ％ of cases,had microcalcification in 40 ％.Cervical lymph node metastasis were found in 40 patients,and 75％ of them were located in zone V[.The smallest size of abnormal lymph node which can be detected by US was 3 mm.In cases of lymph node metastasis,12 cases (30％) became cystic,10 (25 ％) presented microcalcifications,and 5 (12.5 ％) showed microcalcifications and cystic change within a lymph node.Microcalcifications,cystic change and hyperechoic appearance within a lymph node suggested malignant.The detection rate of US and CECT in the local recurrent/residual cancer were 90％ and 90％,respectively.The detection rate of cervical lymph nodes metastasis were 80 ％ and 72.5 ％,respectively.The diagnostic accuracy of US and CECT in local recurrence,cervical lymph node metastasis and both were 65％,67.5％ and 65.2％ vs 75％,55％ and 65.2％,respectively (P ＞ 0.05 for all comparisons).the diagnostic accuracy of combination of US and CECT were increased to 86.4％,77.5％ and 91.3％,respectively.US combined with CECT significantly improved the diagnostic capability compared with US or CECT alone(P ＜0.05).Conclusions US should be used as the first choice of imaging examination for post-thyroidectomy of thyroid cancer.US combined with CECT could further increase the diagnostic accuracy in recurrent/residual thyroid cancer.
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Objective To evaluate the role of contrast-enhanced ultrasound (CEUS) on the the detection of hepatic metastases in comparison with conventional ultrasonography (US) and contrastenhanced computed tomography (CECT).MethodsNinety-seven patients with hepatic metastases underwent US,CEUS and CECT images.Their detection of hepatic metastases were compared.Results Hepatic metastases showed five enhancement patterns with CEUS,including bolus hyper-enhancement,peripheralrimenhancement,inhomogeneousenhancementwithnecrosis,hypo-enhancement,isoenhancement with liver parenchyma,all hepatic metastases showed dark defects in portal and delayed phase.The mean number of metastases at CEUS was greater than that of US (2.6±1.9 vs 1.6 ±1.2,P＜0.05).The detection of hepatic metastases was 53.4％ and 87.1％ respectively(P＜0.05).CEUS and CECT have no statistically significant difference in the detection of hepatic metastases (P＞0.05).ConclusionsCEUS can improve detection of hepatic metastases.
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Objective To review our experience in correction of pectus excavatum.by Nuss procedure without thoracoscopic assistance.Methods 412 patients with pectus excavatum were surgically corrected using Nuss technique without thoracoscopic assistance.There were 329 boys and 83 girls with average age of 7 years and 8 months ( range from 2 years and 8 months to 28 yeats and 5 months).The bars were removed after surgery in 102 patients.Results The operation in all patients had been performed successfully without any severe complications The average time of the operation was 40 minutes.The average blood lose during operation was ( 10 ±2) ml.Conclusion Nuss procedure without thoracoscopic assistance is safety and effective.It could be minimize the trauma and shorter operating time.
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A highly sensitive, rapid and selective liquid chromatography-tandem mass spectrometry(LC-MS/MS) method for the quantitative determination of retinamido-ester in rat plasma was developed and validated. A simplified protein precipitation with acetonitrile was employed for the sample preparation.The separation was carried out on an Agilent TC C18 column ( 150 mm×4. 6 mm ID, 5 μm particle size)with the mobile phase consisted of methanol-water-formic acid (93 : 7 : 0.1). Simvastatin was used as internal standard. The detection was performed on a trap-quadrupele tandem mass spectrometer by selected reaction monitoring (SRM) scan mode via atmospheric pressure chemical ionization (APCI). The range of and inter-day precision values were between 95.97% and 104. 43%, and RSD was between 4. 63% and 10. 69%, respectively. This method was applied to determine the pharmacokinetic parameters. The main pharmacokinetic parameters of retinamido-ester after oral administration via gastric gavage of 2. 5, 5, 10mg·kg-1 were as follows,T1/2;(11.28±7.23),(8.90±3.82),(8.01±5.56)h; AUC0-∞:(103.41±61.46),(190.23±74.99),(421.66±299.20)ng·h·mL-1;MRT:(6.31±0.75),(5.98±0.71), (6.18±0.97) h; CL/F: (30. 10 ± 13.67), (29.58±10.59), (31.18 ±17.51)L·h-1·kg-1;Vd/F:(414.94±159.82),(356.16±139.85),(369.28±322.73)L·kg-1,respectively.
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AIM: To establish an LC-MS/MS method for determination of evodiamine concentration in rat plasma and to study its pharmacokinetic profile in rats. METHODS: Six rats were administrated (i.g.) evodiamine at the dose of 100 mg/kg. Blood samples were collected from eye socket. Evodiamine concentration in rat plasma was determined by LC-MS/MS method. The pharmacokinetic parameters were calculated using DAS program. RESULTS: A good linear relationship was obtained in the concentration range (0.2-50.0 ng/mL) studied (r2=0.9997). Average recoveries ranged from 96.12% to 99.46%. Intra-and inter-day relative standard deviations were 4.61%-13.51% and 5.65%-11.49%, respectively. The main pharmacokinetic parameters of evodiamine were as follows: Cmax (5.3±1.5) ng/mL; tmax (22±8) min; t1/2 (451±176) min. CONCLUSION: A selective and sensitive liquid chromatography-tandem mass spectrometric (LC-MS/MS) method for the quantification of evodiamine in rat plasma is developed and validated. This method is successfully applied for the pharmacokinetic studies of evodiamine in rats.