ABSTRACT
Objective To study the application of intra-luminal ultrasonography (intra-small intestinal ultrasonography,ISIU) in demonstration of normal small intestine and diagnosis of small bowel lesions.Methods From December 2011 to December 2012,ISIU was performed in 50 patients who were screened by capsule endoscopy,gastroscopy,colonoscopy,and double-balloon enteroscopy to observe the normal tissue structures and lesions of the small intestine.Additional abdominal ultrasound (US) and spiral CT (SCT) were applied in patients with identified lesions in small intestine.Results ISIU was completed in 47patients out of 50 enrolled ones.A total of 10 lesions in small intestine were detected,all of them were identified by ISIU,while in which only 1 was found by US and 3 by SCT.Normal small intestinal wall demonstrated 6 layers under ISIU,with slight difference between jejunum and ileum.Conclusion ISIU provides high-resolution image of the structure at all levels of the normal small intestine,and can clearly observe lesion source and internal echo,and thus help to improve the rate of diagnosis of diseases of the small intestine.
ABSTRACT
Objective To study the hemodynamics during closed chest cardiopulmonary resuscitation (CCCPR) in dogs in order to unravel the mechanism. Method Twelve healthy mongrel dogs were selected to make animal model of ventricular fibrillation induced by electric shock on the chest wall. Closed-chest cardiopulmonary resuscitation (CCCPR) was initiated four minutes after ventricular fibrillation appeared according to American Heart Guidelines in 2005 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Rescue. After CPR for 2 minutes, 1mg epinephrine was injected intravenously. The central venous pressure (CVP), the aortic pressure (AOP)and the invasive electrocardiogram (ECG) were used to monitor continuously before ventricular fibrillation and the entire course of CPR. The coronary perfusion pressure (CPP) was calculated. The changes in aortic diastolic pressure (ADP) and CPP produced by chest compression or the injection of epinephrine were analyzed. The aortic pressure and the central venous pressure were recorded simultaneously during CPR. A chart was made and the CPP was calculated with the software Chart5Ch. The hemodynamic changes produced by the administration of epinephrine were studied. Data were analyzed with paired Student t test. P ＜ 0.05 was considered as a significant difference. Results Two kinds of hemodynamic effects of CPR were observed. In 8 dogs (8/12) , the aortic pressure changed synchronously with the CVP, and the CPP was almost zero, and in other 4 dogs (4/12), the aortic pressure increased and the CVP remained unchanged with presence of the CPP. After the administration of epinephrine, the AOP and the CPP increased significantly. The Aortic systolic pressure(ASP) increased from (66± 14) mmHg to(107 ± 28) mmHg, (P = 0. 001). The Aortic diastolic pressure (ADP) increased from (25 ±2.2) mmHg to(45 ± 13) mmHg (P =0.001). And the coronary perfusion pressure (CPP) increased from (2.8± 3.8) mmHg to (29 ± 13) mmHg (P ＜ 0.001). The 95 % confidential interval of the added value of the ASP,ADP and CPPwere (21.1-59.1), (10.2-28.3) and (16.7-35.7), respectively. Conclusions The thoracic pump mechanism is the primary role in the closed chest Cardiopulmonary resuscitation. Epinephrine can increase ADP and CPP and has the capability to break the balance between aortic pressure and central venous pressure, increasing the rate of successful cardiopulmonary resuscitation.
ABSTRACT
Objective To determine the relation between enlarged perihepatic lymph node (PLN) and viraemia,and to find out whether there is a difference in PLN size between the healthy individuals and patients with hepatitis C virus (HCV) infection. Methods Seventy-four patients with HCV infection and 283 healthy individuals were examined by two-dimensional ultrasound. The length and thickness of lymph node were measured. The lymph-node area index(LN area index) was calculated. The LN area index was evaluated by the ROC curve and compared with serum HCV core antigen (HCV-Ag) levels by correlation analysis. Results Detection rate, the length and thickness, LN area index of group with HCV infection were significantly different by compared with the normal control group ( P < 0. 001 ). The ROC curve showed that the LN area index as a diagnostic indicator had high sensitivity and specificity. The LN area index showed a significant correlation with HCV-Ag level (r = 0.436, P <0.05), but no significant differences were found between LN area index and HCV-Ag grade. Conclusions Perihepatic lymphadenopathy indicates viraemia,and LN area index of 100 mm2 is a reference index in estimating whether patients have HCV infection.