Imbalance in matrix metalloproteinases and matrix metalloproteinase inhibitors from diseased splenic vein and varicose great saphenous vein under high hemodynamics / 中国现代普通外科进展

Objective:To investigate the differences in matrix metalloproteinases (MMPs) and matrix metalloproteinase inhibitors (TIMPs) from diseased splenic vein (DSVs) and varicose great saphenous vein (VGSVs) under high hemodynamics.Methods:Seventy-two specimens of DSVs,normal splenic veins (SVs),VGSVs,and normal great saphenous vein (GSVs) were collected.Venous wall in the four groups,MMP-2,MMP-9,TIMP-1,and TIMP-2 protein expression were observed and MMP-2,MMP-9,TIMP-1,TIMP-2 proteins positive expression ratio and mRNA expression were determined.Results:DSVs and VGSVs in the two groups,MMP-2,MMP-9,TIMP-1,TIMP-2 proteins with clustered strong expression were observed;In DSVs group,MMP-2,MMP-9,TIMP-1,TIMP-2 protein positive expression ratio and mRNA expression were significantly increased compared with SVs group,while in VGSVs group,MMP-2,MMP-9,TIMP-1,TIMP-2 protein positive expression ratio and mRNA expression were significantly increased compared with GSVs group (P＜0.05).VGSVs/GSVs ratio was significantly increased compared with DSVs/SVs ratio (P＜0.05).Conclusion:Under high hemodynamics,the dysequilibrium of MMPs and TIMPs from splenic vein and great saphenous vein,These results may be one of the molecular mechanism in vascular remodeling.

Differential diagnostic value of contrast-enhanced ultrasound in calcified thyroid nodules / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic value of contrast-enhanced ultrasound(CEUS) in calcified thyroid nodules.</p><p><b>METHODS</b>A total of 179 cases with calcified thyroid nodules between February 2009 and September 2012 underwent CEUS by injection of microbubbles via superficial vein was included in the study. Pathological diagnosis as a gold standard, the sensitivity, specificity, positive predictive, negative predictive and diagnostic coincidence rate of CEUS were evaluated.</p><p><b>RESULTS</b>Among 110 cases of benign nodules, 62 cases were nodular goiter (46 cases with macrocalcification and 16 cases with microcalcification); 29 cases were adenoma (28 cases with macrocalcification and 1 case with microcalcification); 17 cases were Hashimoto's thyroid (13 cases with macrocalcification and 4 cases with microcalcification); and 2 cases were granuloma with microcalcification. Among 69 cases of malignant nodules (t = 14.33, P < 0.05), 68 cases were papillary carcinoma (60 cases with microcalcification and 8 cases with macrocalcification), and 1 case of medullary carcinoma with microcalcification. Malignant nodules mainly showed weak inhomogeneous enhancement, with the mean; peak intensity (51.38 ± 14.33)dB that was lower than that (92.37 ± 33.36)dB in benign nodules, and benign nodules showed isoenhancement or hyperenhancement, with significant differences compared to malignant nodules (t = 14.33, P < 0.05) , however, there were significant differences in the enhanced time and the time to peak between benign and malignant nodules. The sensitivity, specificity, positive predictive, negative predictive and diagnostic coincidence rate of CEUS for the diagnoses of thyroid nodules were 92.75%, 90.91%, 86.49%, 95.24% and 91.62%, respectively.</p><p><b>CONCLUSION</b>CEUS has high value in differential diagnosis of benign and malignant calcified thyroid nodules.</p>

Logistic regression analysis of contrast-enhanced ultrasound and ultrasonic elastography in differential diagnosis of thyroid nodules / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the contrast-enhanced ultrasound(CEUS) and ultrasonic elastography (UE) in diagnosis of thyroid nodules by a binary Logistic regression model.</p><p><b>METHODS</b>A total 149 cases with thyroid nodules were examed by CEUS and UE and were confirmed by surgical pathology. A Logistic model was obtained on the basis of ultrasonographic features. Receiver operator characteris(ROC) curve was constructed to assess the performance of the Logistic model.</p><p><b>RESULTS</b>Four ultrasonographic features including calcification, enhancement degree, biggest perfusion strength and elastic score were finally entered into the Logistic model. The percentage of correct prediction was 91.90%.</p><p><b>CONCLUSION</b>Both CEUS and UE have high value in differential diagnosis of thyroid nodules and the Logistic regression model has high diagnostic rate.</p>

Thin steel plate with thumbtack fixation in the treatment of massive presacral venous plexus hemorrhage / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Massive presacral venous plexus hemorrhage during radical resection of rectal carcinoma is rare, but when it occurs, bleeding can be uncontrollable, leading to death in some cases. Medical adhesive gauze sticking and packing and thumbtack compressive fixation are often used for hemostasis, but these methods are not effective in cases of uncontrollable massive hemorrhage. Therefore, identifying a practical, accurate, and reliable method of hemostasis in these cases is essential.</p><p><b>METHODS</b>Between January 2004 and December 2009, we treated 3 patients with massive presacral venous plexus hemorrhage during resection of rectal carcinoma by placing small, trimmed thin steel plates at the bleeding sites. The plates were fixed with a saddle-type application of thumbtacks.</p><p><b>RESULTS</b>Bleeding was successfully controlled in all 3 patients, and intestinal anastomosis was carried out after hemostasis. No complications were observed.</p><p><b>CONCLUSIONS</b>Application of a small, thin steel plate to the bleeding site with thumbtack fixation is a simple and effective method of hemostasis in patients with massive presacral venous plexus hemorrhage during resection of rectal carcinoma.</p>