ABSTRACT
Objective To investigate the effect of the proactive percutaneous catheter drainage(PCD)strategy in the treatment of acute pancreatitis(AP)complicated with necrotic infection.Methods A total of 70 patients with AP complicated with necrotic infection and trea-ted by PCD from January 2016 to November 2017 were prospectively enrolled.The patients were randomly divided into the routine group(n=35)and the modified group(n =35)according to the random number table method.The same indication and principle were performed performed during the first time PCD in both of the two groups.However,the subsequent treatment strategy was different between the two groups.The routine group was given a maximum of 1 adjustment of the drainage tube position or another catheterization.If the drainage effect was still poor,the necrosectomy would be taken through laparoscope,nephroscope or laparotomy directly.While the modified group was given frequent and early drain revision and upsizing of drains in case of lack of clinical improvement.The general data,the total number of PCD pro-cedures,the maximal final drain size,the duration between the first two times of PCD,the total drainage duration,the number of patients need for necrosectomy,the length of hospital stay after drainage,the number of patients need for new ICU admission,the number of patients need for readmission,complications and mortality were compared between the 2 groups.Results The total number of PCD procedures and the maxi-mal final drain size of the modified group was significantly higher than that of the routine group(P<0.05 or P<0.01).The duration be-tween the first two times of PCD in the modified group was significantly shorter than of the routine group(P<0.01).The ratio of patients need for necrosectomy and suffered new-onset multiple organ failure significantly decreased in the modified group,and the difference was sta-tistically significant(P<0.05).There was no significant difference between the two groups in total days of drainage,length of hospital stay after drainage,number of patients need for new ICU admission,number of patients need for readmission,complications and mortality.Conclu-sion The proactive PCD strategy of frequent and early drain revision and upsizing of drains for patients with acute infected necrotizing pan -creatitis when lack of clinical improvement can reduce the proportion of recurrent multiple organ failure and the need for necrosectomy,and it does not increase the risk of related complications.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the safety and efficacy of frameless stereotactic brain biopsy.</p><p><b>METHODS</b>Diagnostic accuracy was calculated by comparing biopsy diagnosis with definitive pathology in 62 patients who underwent frameless stereotactic brain biopsy between January 2008 and December 2010 in Xiamen University Southeast Hospital. Preoperative characteristics and histological diagnosis were reviewed and then information was analysed to identify factors associated with the biopsy not yielding a diagnosis and complications.</p><p><b>RESULTS</b>Diagnostic yield was 93.5%. No differences were found between pathological diagnosis and frozen pathological diagnosis. The most common lesions were astrocytic lesions, included 16 cases of low-grade glioma and 12 cases of malignant glioma. Remote hemorrhage, metastasis, and lymphoma were following in incidence. Multiple brain lesions were found in 17 cases (27.4%). Eleven cases were frontal lesions (17.7%), 8 were frontotemporal (12.9%), 6 were frontoparietal (9.7%), and 5 each were temporal, parietal, and parietotemporal lesions (8.1%). Postoperative complications occurred in 21.0% of the patients after biopsies, including 10 haemorrhages (16.1%) and 3 temporary neurological deficits (1 epilepsy, 1 headache, and 1 partial hemiparesis). No patient required operation for hematoma evacuation.</p><p><b>CONCLUSION</b>Frameless stereotactic biopsy is an effective and safe technique for histologic diagnosis of brain lesions, particularly for multifocal and frontal lesions.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Biopsy , Methods , Brain , Pathology , Stereotaxic TechniquesABSTRACT
<p><b>OBJECTIVE</b>To detect 3-dimensional images of anti-N-methyl-D-aspartate receptor Nr1 (NMDAr1) polycolonal IgG affixed on mica in physiological environment.</p><p><b>METHODS</b>The images and data were obtained from a contact mode and commercial Si3N4 probed tip by using atomic force microscope (AFM).</p><p><b>RESULTS</b>The anti-NMDAr1 polycolonal IgG has a characteristic structure described as an ellipse spherical shape of 136.4 A x 62.8 A x 26.1 A. On the section of the ellipse edge there were two peaks about 13 nm in width.</p><p><b>CONCLUSIONS</b>Using AFM to investigate biomacromolecule can make us deeply understand the structure of IgG, which will instruct us to detect the membrane receptor protein as a labelling agent.</p>