Practice and progress of interventional ultrasound in the diagnosis and treatment of acute abdomen / 国际外科学杂志

Acute abdominal pain is one of the most frequent complaints of patients presenting to the emergency department. Timely diagnosis and correct treatment affect the prognosis of patients. Traditional diagnosis mostly depends on physical examination and radiology. In terms of treatment, some patients need exploratory laparotomy. In recent years, with the development of interventional ultrasound, new techniques such as contrast-enhanced ultrasound, ultrasound-guided biopsy, drainage have been gradually applied to the diagnosis and treatment of surgical acute abdomen, especially the surgeon-performed interventional ultrasound, which has effectively improved the diagnostic efficiency and broadened the treatment choice. In this article, we aim to review and evaluate the application and progress of interventional ultrasound in the diagnosis and treatment of surgical acute abdomen.

Effect analysis of preoperative embolization combined with microsurgery for the treatment of intracranial arteriovenous malformation / 中国脑血管病杂志

Objective To evaluate the treatment effect of using preoperative embolization combined with microsurgery for the treatment of intracranial arteriovenous malformation.Methods From January 2005 to December 2015,57 consecutive patients with intracranial arteriovenous malformation (AVM ) admitted to the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were enrolled retrospectively. They were diagnosed by magnetic resonance imaging (MRI)and digital subtraction angiography (DSA). Glubran and/or Onyx embolization was used before the microsurgery. The clinical features,treatment, and occurrence of complications were recorded.Results In 57 patients,the Spetzler-Martin grade in 35 patients were gradeⅠ-Ⅱ,in 18 were Ⅲ,and in 4 were Ⅳ. The complications occurred in 11 patients (19. 3%),including 5 with Onyx,5 with Glubran,and 1 with Onyx+Glubran. After embilization,4 patients had hemorrhage,2 had intracranial hemorrhage,1 had postoperative intracranial infection,1 had postoperative neuro-logical dysfunction,and 3 had other systemic complications after procedure. The complication rates were 14. 3%(5/35)and 22. 2%(4/18)respectively according to the Spetzler-Martin grade Ⅰ-Ⅱ and Ⅲ. Two patients of Spetzler-Martin gradeⅣhad complications. The incidence of complications in the functional areas was 20. 0%(4/20)and that in non-functional areas was 18. 9%(7/37). One patient died. DSA revealed that 4 patients had residual lesions before discharge. The cure rate was 93. 0%. The mean modified Rankin scale (mRS)score at discharge was 1. 6 ± 1. 0. The patients of mRS 0-1 accounted for 59. 6%(34/57).The mRS scores in 7 patients at discharge were higher than before treatment.Conclusion For the high-grade AVM foci with larger volume and in the deep part of brain,the treatment with microsurgery combined with embolization can be considered.