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Objective To evaluate the value of magnetic resonance spectroscopy (MRS) in the diagnosis of intracranial space-occupying lesions. Methods A total of 126 patients with intracranial space-occupying lesions in the First Affiliated Hospital of Xinjiang Medical University from 2019 to 2022 were enrolled and subjected to brain magnetic resonance imaging (MRI) and MRS examinations. The performance of MRI alone and in combination with MRS was evaluated and compared for diagnosis of intracranial space-occupying lesions. Results Tuberculoma (19.05%) and high-grade glioma (15.87%) were the intracranial space-occupying lesions most commonly diagnosed by MRI in combination with MRS. Radiologists confirmed the diagnosis of intracranial space-occupying lesions in 23.81% patients depending on MRI alone, and in 75.40% patients depending on MRI combined with MRS, with a 2.17-fold improvement (χ2 = 67.07, P<0.01). The combination of MRI and MRS improved the accuracy of imaging diagnosis of intracranial space-occupying lesions in 70 (55.67%) patients compared with MRI alone. In addition, MRI in combination with MRS significantly improved the accuracy of differential diagnosis of high-grade glioma, low-grade glioma, cerebral infarct, tuberculoma, recurrent tumor, and radiation necrosis compared with MRI alone (P<0.01). Conclusion The efficacy of imaging diagnosis of intracranial space-occupying lesions can be improved by MRI in combination with MRS relative to MRI alone. The combined use of MRI and MRS may serve as a non-invasive tool for diagnosis of intracranial space-occupying lesions. In addition, the combination facilitates the differentiation between low- and high-grade gliomas, between high-grade glioma and tuberculoma, and between recurrent tumor and radiation necrosis.
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Objective:To investigate the clinicopathological characteristics and prognosis of idiopathic membranous nephropathy (IMN) with or without C3 deposition.Methods:Clinical and pathological data of 576 patients with IMN diagnosed in Affiliated Hospital of Qingdao University from January 2017 to January 2021 were retrospectively analyzed. The patients were divided into C3 deposition group and non-C3 deposition group according to the immunofluorescence staining of C3. The clinical and pathological characteristics were compared between the two groups. Kaplan-Meier survival curve was used to compare the prognosis of the two groups.Results:A total of 576 IMN patients (male 364 (63.20%)) were enrolled, including 400 patients (69.44%) with C3 deposition and 176 patients (30.56%) without C3 deposition. Compared with the non-C3 deposition group, the levels of total blood cholesterol ( t=0.94, P=0.002) and the proportion of phospholipase A2 receptor ( χ2=9.99, P=0.002), IgG ( χ2=10.67, P=0.001), IgM ( χ2=7.00, P=0.008), IgA ( χ2=7.87, P=0.005) and C1q ( χ2=8.28, P=0.004) depositions in renal tissues was higher in C3 deposition group, while the levels of serum C3 ( t=2.87, P=0.004), albumin ( t=3.57, P<0.001) and IgG ( Z=3.55, P<0.001) were lower in C3 deposition group. There were no significant differences in other clinicopathological indicators between the two groups. The survival analysis was performed in 460 patients who were followed for>6 months, including 319 cases (69.35%) of C3 deposition and 141 cases (30.65%) of non-C3 deposition. The end point event was defined as an eGFR decline>30% or entry into end stage renal disease (ESRD). There was no statistically significant difference in treatment method between the two groups ( P>0.05). The median follow-up time was 22 (13,32) months, 327 (71.09%) patients achieved remission, and 22 patients had renal end-point events. Compared with the non-C3 deposition group, the proportion of urinary protein remission was lower ( χ2=10.85, P<0.05), the incidence of renal end-point events was higher ( χ2=5.05, P<0.05). Kaplan-Meier survival analysis showed that patients with C3 deposition had a lower cumulative remission rate (Log-rank χ2=6.68, P=0.010), and a lower cumulative renal survival than those without C3 deposition had ( χ2=5.42, P=0.020). Conclusions:Compared with patients without C3 deposition, IMN patients with C3 deposition have more severe clinical and pathological changes, lower renal cumulative remission rate, and are more likely to have poor prognosis.
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Objective:To observe the emulsification of silicone oil in eyes with rhegmatogenous retinal detachment (RRD) after silicone oil filling surgery, and to preliminarily analyze the possible clinical factors related to it.Methods:A cross-sectional clinical study. From January 2019 to April 2022, 50 eyes of 50 patients with RRD who underwent pans plana vitrectomy (PPV) combined with silicone oil filling surgery in Eye and ENT Hospital of Fudan University were included in the study. Among them, there were 25 males with 25 eyes and 25 females with 25 eyes; the age was 54.86±11.79 years old. The retina was in place 3 months after surgery. Before silicone oil removal surgery, intraocular pressure >21 mm Hg (1 mm Hg=0.133 kPa) or treated with≥1 anti-glaucoma drug (high intraocular pressure) in 20 eyes; intraocular pressure ≤21 mm Hg and no anti-glaucoma drug treatment in 30 eyes (normal intraocular pressure). During follow-up after surgery, silicone oil emulsification was found and those who met the indications for silicone oil removal were subjected to silicone oil removal surgery. The first 2 ml of lavage fluid was collected immediately after removal of the silicone oil, and the particle diameter and number of emulsified silicone oil were measured using a Multisizer ? 3 particle/cell counter and particle size analyzer. The measuring range was 0.4-12.0 μm, and the diameter is accordingly divided into 0.4-<1.0, 1.0-<3.0, 3.0-<5.0, 5.0-<7.0, 7.0-12.0 μm. Each sample was measured 3 times and the average value was taken. Spearman correlation analysis and multiple linear regression analysis were used to analyze the correlation between the number of emulsified silicone oil particles and clinical factors. Results:The number of emulsified silicone oil particles was (1.74±2.94)×10 7/ml (0.96×10 7-14.11×10 7/ml), of which the diameter of 0.4-<1.0 μm emulsified silicone oil particle was (1.25±2.41)×10 7/ml, accounted for (64.26±12.70)% [(1.25±2.41)×10 7/(1.74±2.94)×10 7]. The results of correlation analysis showed that there was no correlation between the total particle number of emulsified silicone oil and various clinical factors ( P>0.05). The number of emulsified silicone oil particles with a diameter of 7.0-12.0 μm was negatively correlated with age ( r=-0.298, P=0.036), and positively correlated with axial length ( r=0.325, P=0.021). There was no correlation between the previous ocular trauma, choroidal detachment and different lens states and the number of emulsified silicone oil particles ( P>0.05). Multiple linear regression analysis showed that eye axis ( β=1 570.868, P=0.023) and age ( β=-316.128, P=0.039) were the risk predictors of silicone oil emulsification into large diameter particles (7-<12 μm). The number of emulsified silicone oil particles with a diameter of 7-12 μm in the patients with high intraocular pressure was significantly higher than that in the patients with normal intraocular pressure, and the difference was statistically significant ( U=195.00, P=0.037). Conclusions:Most of the emulsified silicone oil particles in the eyes of RRD patients after silicone oil filling surgery are small-diameter particles; the silicone oil emulsification is more serious in young patients and patients with long ocular axis, and young patients are more prone to high intraocular pressure.
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Objective:To investigate the characteristics and risk factors of infection in newly diagnosed patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).Methods:The clinical data of AAV patients (followed up for at least 6 months) in Affiliated Hospital of Qingdao University from September 2012 to September 2020 were retrospectively collected. According to whether infection occurred during follow-up, the patients were divided into infection group and non-infection group. The clinical characteristics and infection status of the two groups were analyzed, and the Cox regression analysis model was used to explore the influencing factors of infection.Results:A total of 236 AAV patients were enrolled in this study, including 128 females (54.2%) and 108 males (45.8%), with a median age of 66.00 (59.76, 71.99) years. There were 202 patients (85.6%) with positive myeloperoxidase (MPO)-ANCA and 34 patients (14.4%) with positive protease 3 (PR3) -ANCA. There were 77 cases in the infection group and 159 cases in the non-infection group. A total of 121 infections occurred in 77 patients, and 54 infections (44.6%) occurred within 6 months after initial diagnosis. In the infection group the proportion of patients with hypertension history, pulmonary underlying diseases and patients who received hormone pulse therapy or plasma exchange, the incidence of lung, kidney, heart and gastrointestinal involvement, the level of serum creatinine and five factors score (FFS) at initial diagnosis were significantly higher than those in the non-infection group (all P<0.05), while the estimated glomerular filtration rate (eGFR) was significantly lower ( P<0.05). Lung (73.6%) was the main infection organ of AAV patients. The most common pathogenic microorganisms were bacteria (64.0%), mainly Pseudomonas aeruginosa and Staphylococcus aureus, followed by fungi (33.7%, mainly Candida albicans). Multivariate Cox regression analysis showed that lung involvement ( HR=1.682, 95% CI 1.034-2.734, P=0.036) and gastrointestinal involvement ( HR=2.976, 95% CI 1.219-7.267, P=0.017) were the independent influencing factors for infection in AAV patients. Conclusions:AAV patients have a higher incidence of infection within 6 months after initial diagnosis. The most common organ of infection in AAV patients is the lung, and the common pathogens are Pseudomonas aeruginosa, Staphylococcus aureus and Candida albicans. Lung involvement and gastrointestinal involvement are the independent risk factors for infection in AAV patients.
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Objective:To discuss the occurrence, treatment and prevention of benign anastomotic stenosis after radical resection for rectal cancer.Methods:The clinical data of 63 patients with benign anastomotic stenosis from Jan. 2016 to Dec.2020 at Department of Gastrointestinal Surgery, Renji Hospital Shanghai Jiaotong University School of Medicine, were retrospectively analyzed, including general conditions, intraoperative conditions, postoperative complications, anastomotic stenosis, treatment process and outcome. The relationship between stenosis type and treatment and outcome were analyzed.The measurement data obeying normal distribution was expressed by ( Mean± SD), and the t test was used comparison between groups. The chi-square test was used comparison between enumeration data. Results:Of all the 63 patients, 22 (34.9%) cases presented with membranous stenosis, 30 (47.6%) cases with tubular stenosis, and 11 (17.5%) cases with diffused stenosis. Three of the 9 patients with high stenosis underwent balloon dilatation through endoscopy, 3 were placed with self-expandable metal stent and the rest 3 patients underwent resection and reconstruction of the anastomosis. All the 54 patients with low stenosis underwent digital anal expansion, and finally the effective rate was 53.7% (29/54). Endoscopic balloon dilatation was successfully performed in 8 cases, including 4 cases were placed metal stent throngh endoscopy. Eight patients underwent trans-anal stricturotomy. In 5 patients with low diffused stenosis, either ileostomy was preserved or permanent colostomy was performed due to failure to treatment. There were more male patients, protective ileostomy, anastomotic leakage and low stenosis in patients failed to treatment than in the cured patients ( P>0.05). However, all the 5 patients who failed to treatment were suffered from diffused stenosis, and the difference was statistically significant compared with those who were cured ( P<0.05). Conclusions:Postoperative anastomotic stricture after anterior rectectomy requires different treatment strategies according to the location and types of stricture. Endoscopic balloon dilatation is preferred for high stenosis, and metal stents can be placed optionally. Digital anal expansion is preferred for low anastomotic stenosis, and endoscopic or minimally invasive transanal surgery is feasible if digital anal expansion fails.
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Objective:To analyze the efficacy of blood purification (BP) in the treatment of moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP).Methods:The clinical data of 102 patients of MSAP and SAP in Changhai Hospital affiliated with Navy Medical University from December 2015 to March 2019 were retrospectively analyzed. According to the treatment method and prognostic outcome, patients were divided into control group ( n=46) and BP group ( n=56), control survival group ( n=43), and control death group ( n=3), BP survival group ( n=37) and BP death group ( n=19), respectively. Based on BP treatment duration each time, BP group was sub-divided into BP short-term group (4 h≤T<8 h, n=38) and BP long-term group (8 h≤T≤12 h, n=18). General data, laboratory findings, complications, average daily hospitalization cost, prognosis and effects of BP duration on the blood urea nitrogen improvement were recorded. Results:Compared with control survival group, BP survival group had lower levels of lactic acid, urea nitrogen and other metabolites, and SIRS duration was significantly shortened [12(7, 16) days vs 5(3, 9) days, HR=0.19, 95% CI 0.11-0.35, P<0.0001]. The clearance of urea nitrogen in BP short-term group was more obvious than BP long-term group (χ 2==4.44, P=0.035). APACHEⅡ score on admission( OR=1.33, 95% CI 1.087-1.617, P=0.005) and numbers of organ failure ( OR=3.445, 95% CI 1.426-8.323, P=0.006) were important risk factors affecting MSAP and SAP prognosis under BP therapy. For patients with extremely poor prognosis, it was still difficult for BP to reverse the progression trend and prognosis of MSAP and SAP. Conclusions:BP can effectively remove accumulated metabolites at acute stage and shorten the duration of SIRS. BP duration of 4-8 h each time may be more conducive for improving the severity of the disease.
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Objective:To investigate the influencing factors for anastomotic leakage after transabdominal transanal total mesorectal excision.Methods:The retrospective case-control study was conducted. The clinicopathological data of 50 patients with rectal cancer who were admitted to the Renji Hospital of Shanghai Jiaotong University School of Medicine from December 2017 to November 2018 were collected. There were 34 males and 16 females, aged (60±11)years, with a range from 31 to 84 years. All the patients underwent transabdominal transanal total mesorectal excision. Observation indicators: (1) anastomotic leakage after transabdominal transanal total mesorectal excision; (2) analysis of influencing factors for anastomotic leakage after transabdominal transanal total mesorectal excision; (3) effects of learning curve on anastomotic leakage after transabdominal transanal total mesorectal excision. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages. Univariate analysis was conducted using the chi-square test, and multivariate analysis was conducted using the Logistic regression model. Results:(1) Anastomotic leakage after transabdominal transanal total mesorectal excision: of the 50 patients, 9 had postoperative anastomotic leakage, including 6 of grade A anastomotic leakage (2 patients receiving protective enterostomy), 2 of grade B anastomotic leakage, and 1 of grade C anastomotic leakage. Of the 9 patients with anastomotic leakage, there were 5 males and 4 females, aged 62 years (range, 40-75 years). The 9 patients had a body mass index of 27 kg/m 2 (range, 21-31 kg/m 2), and a distance from anastomosis to anal edge of 30 mm (range, 5-40 mm). (2) Analysis of influencing factors for anastomotic leakage after transabdominal transanal total mesorectal excision: results of univariate analysis showed that anastomotic method and protective stoma were related factors for anastomotic leakage after transabdominal transanal total mesorectal excision ( χ2=5.490, 5.456, P<0.05). Results of multivariate analysis showed that anastomotic method and protective stoma were not independent factors for anastomotic leakage after transabdominal transanal total mesorectal excision ( odds ratio=0.062, 0.460, 95% confidence interval: 0.009-1.119, 0.102-2.809, P>0.05). (3) Effects of learning curve on anastomotic leakage after transabdominal transanal total mesorectal excision: with the passing of learning curve and the use of protective stoma, 11 of the first 25 patients of learning cure underwent protective stoma and 6 had postoperative anastomotic leakage, while 20 of the last 25 patients of learning cure underwent protective stoma and 3 had postoperative anastomotic leakage. There was no significant difference in the postoperative anastomotic leakage between them ( χ2=1.220, P>0.05). Conclusion:Anastomotic method and protective stoma are related factors influencing anastomotic leakage after transabdominal transanal total mesorectal excision.
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Objective@#To compare the therapeutic value of transnasal gastroscopy and conventional gastroscopy for infective pancreatic necrosis(IPN) through percutaneous endoscopic necrosectomy(PEN).@*Methods@#A total of 24 IPN patients who received PEN for IPN from December 2015 to March 2019 were divided into the conventional gastroscopy group (n=15) and the transnasal gastroscopy group (n=9). The clinical therapeutic indicators such as vital signs, APACHE Ⅱ score changes, operation duration, difference in preoperative and postoperative volumes of peripancreatic necrosis and other indicators were compared between the two groups.@*Results@#There was no significant difference in the variation curve fitting of APACHE Ⅱ scores between the two groups (t=0.378, P=0.710). The operation time of the transnasal gastroscopy group was significantly shorter than that of the conventional gastroscopy group (119.7±47.4 min VS 172.8±56.2 min, P=0.018). Peripancreatic necrotic volume significantly decreased after operation in the transnasal gastroscopy group (404.03±170.73 mL VS 468.9±137.37 mL, P=0.002), and in the conventional gastroscopy group (499.44±227.17 mL VS 722.50±292.96 mL, P<0.001). There was no significant difference in the decrease extent in the conventional gastroscopy group and the transnasal gastroscopy group (223.06±212.92 mL VS 64.87±54.94 mL, P= 0.094).@*Conclusion@#On the condition of poor drainage of percutaneous catheter drainage, PEN can significantly reduce the range of necrotic lesions. Transnasal gastroscopy has the advantages in operation time in PEN and clearing deep abscess cavities over conventional gastroscopy.
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With the increasing standardization of right colon cancer radical resection, more emphasis is put on keeping the mesentery intact along with vascular root ligation and extensive lymph nodes dissection which inevitably demands higher level of surveillance on the possible complications especially around gastrocolic trunk with large variation of tributary and complex vascular course, to achieve a successful surgical and oncological outcome. This article discusses the complex anatomy of the gastrocolic trunk and its implication in the choice of surgical approaches.
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Objective@#Non-technical skills (NTS) are necessary to evaluate the comprehensive quality of surgeons. In this study, we proposed the concept of C-NTS, a scoring criterion for NTS based on real scenarios (for example, history taking) and video recording, and verified its practical application effects.@*Methods@#Study objects were divided into the tutor group and the student group. The tutor group contained four senior attending physicians in gastrointestinal surgery department of one tertiary hospital (all male with doctor degree). The student group had four rotating surgeons who were randomly selected from the same department in 2018 (two males and two females). Before and after the training, the tutor rated the same anonymous video by C-NTS. One-factor analysis of variance was used to compare the differences between and within the groups, and Kendall concordant coefficient was used to test the consistency by SPSS 22.0.@*Results@#After the tutor receiving training, Kendall concordant coefficient was increased from 0.425 to 0.853 and the latter suggested the difference had statistical significance (P=0.017), which confirmed the effectiveness of the training.@*Conclusion@#C-NTS has preliminarily solved the difficulty of homogenization of NTS assessment. Relevant C-NTS discussions and trainings for clinical tutors may be beneficial to save time and manpower in clinical teaching and evaluation.
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Objective Non-technical skills (NTS) are necessary to evaluate the comprehensive quality of surgeons.In this study,we proposed the concept of C-NTS,a scoring criterion for NTS based on real scenarios (for example,history taking) and video recording,and verified its practical application effects.Methods Study objects were divided into the tutor group and the student group.The tutor group contained four senior attending physicians in gastrointestinal surgery department of one tertiary hospital (all male with doctor degree).The student group had four rotating surgeons who were randomly selected from the same department in 2018 (two males and two females).Before and after the training,the tutor rated the same anonymous video by C-NTS.One-factor analysis of variance was used to compare the differences between and within the groups,and Kendall concordant coefficient was used to test the consistency by SPSS 22.0.Results After the tutor receiving training,Kendall concordant coefficient was increased from 0.425 to 0.853 and the latter suggested the difference had statistical significance (P=0.017),which confirmed the effectiveness of the training.Conclusion C-NTS has preliminarily solved the difficulty of homogenization of NTS assessment.Relevant C-NTS discussions and trainings for clinical tutors may be beneficial to save time and manpower in clinical teaching and evaluation.
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With the increasing standardization of right colon cancer radical resection,more emphasis is put on keeping the mesentery intact along with vascular root ligation and extensive lymph nodes dissection which inevitably demands higher level of surveillance on the possible complications especially around gastrocolic trunk with large variation of tributary and complex vascular course,to achieve a successful surgical and oncological outcome.This article discusses the complex anatomy of the gastrocolic trunk and its implication in the choice of surgical approaches.
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Objective To explore the effect of 1-alpha,25-dihydroxy-cholecalcifero(1,25(OH)2D3)on liver fibrosis and its mechanism. Methods Degree of liver fibrosis was assessed through pathological detection and blood biochemical examination of liver function. Immunohistochemical assay was used to detect expressions of α-SMA,TGF-βand collagen I to observe activation level of hepatic stellate cells. Impact of 1,25(OH)2D3 on CD4+T cell differentiation was analyzed by flow cytometry,ELISA,and RT-PCR. Results 1,25(OH)2D3 improved the structure of the liver tissue and liver fibrosis. Expressions of collagen I ,TGF-βandα-SMA were significantly ele-vated in the liver tissue in rats with fibrosis(P 0.01);and ex-pressions of RORγt and T-bet decreased whereas GATA3 expression increased(P>0.01);as compared with those in the control group. Conclusions 1,25(OH)2D3 can alleviate the degree of liver tissue by lowering HSC activation and regulating Th cell differentiation.
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Objective To investigate the mechanism and effect of the spinal cord outlet of the skull base on Chiari Ⅰ malformation with syringomyelia.Methods The cervical spinal cord stem angle (Anbc),slope angle of cervical vertebra (Ansc) of Chiari Ⅰ malformation were measured.In foramen magnum (Llf) and anterior vertebral canal level (Laf),spinal canal(Ac),spinal cord (As) and inferior hernia area (Ah) were measured.Angle,area and ratio were compared in Chiari Ⅰ malformation with syringomyelia,Chiari Ⅰ malformation without syringomyelia and normal control group.Results Ansc,Anbc-Ansc had significant differences among control group and Chiari Ⅰ malformation patients (all P＜0.001).In Llf,Laf,As had significant differences among three groups (all P＜0.05),further comparison of the two showed there were significant differences between Chiari Ⅰ malformation with syringomyelia patients and control group,Chiari Ⅰ malformation without syringomyelia patients and control group in Llf(all P＜0.05).In Llf,Laf,Ac in Chiari Ⅰ malformation with syringomyelia was smaller than control group (P＜0.05).Ah in Llf,Lafand Lh in Llf had no statistical significant difference between Chiari Ⅰ malformation with and without syringomyelia patients (all P＞0.05).In Llf,Laf,As/Ac had statistical significant difference among Chiari Ⅰ malformation with and without syringomyelia patients,control group (all P＜0.001),further comparison of the two showed As/Ac in Llf had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group (P＜0.05),As/Ac in La had statistical significance difference between Chiari Ⅰ malformation with syringomyelia patients and control group,between Chiari Ⅰ malformation without syringomyelia patients and control group (all P＜0.05),Conclusion The cervical spinal cord,Ansc reducing,narrow vertebral proportion increase are important factors to promote Chiari Ⅰ malformation syringomyelia.
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Objective To build experimental animal model of cerebral alveolar echinococcosis disease of sheep,in order to study of human alveolar hydatid disease of the brain.Methods Experiment animal models of ten Xinjiang big-tail sheep were performed by, direct skull puncture,intracerebral inoculation of echinococcus multilocularis.MRI was used to observe the growth status of cerebral alveolar echinococcosis disease of sheep after 8 months,and morphological and pathological characteristics after autopsy were ana-lysed.Results 4 sheep models (40%)were successful built which were confirmed by pathology and MRI.On MRI,4 cases all were single lesion,on T2 WI there was multiple follicles bubbles under the background of low signal in one case,and low signal in other three cases.Under the microscope,a large number of lymphocytes,eosinophils and plasma cells infiltrated the lesion area,around which small blood vessels were blocked and had inflammatory reaction were showed.Conclusion The method using artificial inocula-tion rat alveolar echinococcosis to establish experimental model of cerebral alveolar echinococcosis disease of sheep has the character-istic of feasibility,simplicity and repeatability.
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Standardization of residency training aims to improve the overall quality of residents and bring up high-quality medical students.Research capabilities and innovative spirit of young physicians play important roles in the sustainable development of hospitals.This article describes the experience in strengthening research training in the United States residency program,provides recommendations to resolve the problems of our residency standardized training and new ideas for the domestic medical institutions to strengthen the young physicians' sense of innovation and scientific research ability.
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Objective To observe the difference in activated brain regions when speaking Mandarin and Uyghur.Methods Blood oxygenation level dependent magnetic resonance imaging (BOLD-fMRI) was used to scan the brains of 30 healthy,right handed volunteers-15 native Uyghur speakers and 15 native Mandarin speakers-while they performed semantic identification and verb generation tasks.The fMRI data were used to generate statistical parametric maps of the brain areas activated by each task.Results In the semantic identification task the left anterior cingulate gyrus (BA23) and the midline mesophyll wedge were activated significantly more strongly in the Uyghur group compared with the Mandarin speakers.In the verb generation task the left inferior temporal gyrus (BA37),the inferior parietal lobule,the fusiform gyrus and the parahippocampal gyrus in the Uyghur group were all significantly more active.The right superior temporal gyrus (BA38) in the Mandarin group was significantly more active during verb generation than among the Uyghur speakers.Conclusions The brain regions activated during semantic processing and verb generation differ when speaking Uyghur and Mandarin.The cingulate gyrus and the praecuneus are more involved in Uyghur-language semantic processing,especially the left anterior cingulate gyrus.The right hemisphere is more important in Mandarin processing than in Uyghur.
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Objective To investigate the effect of different operations for cardia carcinoma on the postoperative anastomotic stoma complications.Methods Between December,2000 and May,2007,the clinical data 156 patients with carcinoma of gastric cardia who received different operations were analyzed retrospectively.Results The thoracoabdominal incision was performed in 57 cases,abdominal incision in 68 and left thoracic incision in 31 cases.The occurrence rate of anastomotic stoma complications in the patients with thoraco-abdominal,abdominal and left thoracic incision was 7.0%(4/57),7.4%(5/68),and 12.9%(4/31),respectively.The occurrence rate of anastomotic stoma complications in the patients using 25 mm end-end autosuture was 4.2%(4/95),in using of the 28mm autosuture group was 16.1%(P=0.0102).Conclusions The occurrence rate of anastomotic stoma complications can be reduced by choosing correct operation methods and using autosuture correctly.
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Objective To observe the characteristics of images of optic coherence tomography (OCT) for the macular region of congenital retinoschisis and investigate its significance. Methods The data of OCT of 11 patients (20 eyes) with congenital macular retinoschisis diagnosed by direct or preplaced-mirror ophthalmoscopy, fundus fluorescein angiography (FFA), and electroretinography (ERG) were retrospectively analyzed. Results The images of OCT showed split in the mid portion of sensory retina at the macula in all eyes. The retina of fovea centralis was divided by the split into two slightly thickening layers. In addition, in a few number of cases, the parafoveal sensory retina which became much thickening with 2 splits, was divided into 3 layers. Conclusion The characteristic of images of OCT in macular congenital retinoschisis is the split cavity at the middle layer of the retina, and OCT has a high sensitivity in the diagnosis of congenital retinoschisis.