Clinical Value of Ultrasound in Evaluating Stent Placement for Managing Graft Stenosis after Meso-rex Bypass / 中国医学科学院学报

Objective To explore the feasibility of using ultrasound to evaluate stent placement for managing graft stenosis after Meso-rex bypass for cavernous transformation of the portal vein in adults. Methods This study enrolled the patients who underwent Meso-rex bypass due to cavernous transformation of the portal vein,were diagnosed graft stenosis by postoperative ultrasound,and then underwent percutaneous portal vein puncture portography and stent placement.We then compared the ultrasonic measurement indicators and sonographic manifestations before and after stent placement,and evaluated the alleviation of portal hypertension symptoms after stent placement and related clinical indexes. Results Finally,8 patients were enrolled in this study,including 5 males and 3 females,with an average age of(32.4±14.7)years.The median duration of follow-up was 26 months after stent placement.The mean diameter of graft stenosis was(2.74±0.23)mm after Meso-rex bypass and became wider[(7.23±0.68)mm]after stent placement(

Baicalin Reduces Early Brain Injury after Subarachnoid Hemorrhage in Rats / 中国结合医学杂志

OBJECTIVE@#To evaluate the effect of baicalin on subarachnoid hemorrhage (SAH) in rats and explore the potential mechanisms.@*METHODS@#Sprague-Dawley rats underwent experimental SAH and received treatment with baicalin at 10 or 50 mg/kg after 2 and 12 h of SAH. Neurological scores, brain water content, Evans-blue extravasation, and levels of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), myeloperoxidase (MPO), and malondialdehyde (MDA) were measured 24 h after SAH. Expression of nuclear factor erythroid-related factor 2 (Nrf2), NAD(P)H: quinone oxidoreductase 1 (NQO1), matrix metalloproteinase-9 (MMP-9), aquaporin 4 (AQP4), occludin, and zonulaoccludens-1 (ZO-1) were detected in the brain by Western blot. Heme oxygenase-1 (HO-1) was detected by quantitative polymerase chain reaction, and tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were assessed by enzyme-linked immunosorbent assay.@*RESULTS@#Baicalin attenuated EBI 24 h after SAH in rats (P<0.05). Baicalin elevated neurological scores, GSH-Px, SOD, and increased the expression of Nrf2, NQO1, HO-1, occludin, and ZO-1 in SAH rats (P<0.05 or P<0.01). Baicalin reduced MPO, MDA, and the expression of MMP-9, AQP4, TNF-α, and IL-1β (P<0.05 or P<0.01).@*CONCLUSION@#Baicalin reduced SAH-induced EBI, partially via activation of the Nrf2/HO-1 pathway and inhibition of MMP-9 and AQP4.

Ultrasound screening and follow-up study of congenital anomalies of the kidney and urinary tract in neonates / 北京大学学报(医学版)

OBJECTIVE@#To investigate the incidence of congenital anomalies of the kidney and urinary tract (CAKUT) in neonates, and to evaluate the value of urinary ultrasound screening in the early postnatal period.@*METHODS@#The neonates born or treated in Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University between January 2016 and December 2018 accepted the urinary ultrasound screening, and the neonates with problem were followed up. In the meanwhile, the maternal pregnancy data were analyzed to screen out the risk factors associated with the onset of CAKUT.@*RESULTS@#(1)A total of 2 655 neonates were screened by ultrasonography, of whom 82 neonates had been diagnosed with CAKUT (male: 60 cases, female: 22 cases), the positive rate was 3.1% (82/2 655). There were 66 cases of hydronephrosis, 6 cases of duplicate kidney, 2 cases of multiple renal cysts, 2 cases of renal cystic dysplasia, 1 case of medullary sponge kidney, 3 cases of small kidney, 1 case of isolated kidney, and 1 case of horseshoe kidney. (2)Of the 66 children with hydronephrosis, 4 cases were lost to the follow-up; 8 cases were followed for less than six months with no significant changes found, and still in the follow-up observation; 54 cases were followed up for 1 year, among which 32 cases were returned to normal within 1 year, 3 cases were alleviated, 7 cases were aggravated, and 12 cases were unchanged. One case underwent surgery for repeated urinary tract infections and decreased renal function. (3) Abnormal fetal urinary ultrasound in the late pregnancy was found to be the most common in the high risk factors of CAKUT. There were 44 high-risk newborns with abnormal fetal urinary ultrasound, and 35 cases of CAKUT were diagnosed after birth. The incidence rate was 79.5%(35/44). (4)Among the 2 655 newborns screened, 2 611 newborns had normal antenatal urinary ultrasonography. Among these neonates with normal urinary ultrasound during pregnancy,47 cases of CAKUT were diagnosed after birth, with an incidence of 1.8% (47/2 611).@*CONCLUSION@#The most common CAKUT in neonates is hydronephrosis and most cases with hydronephrosis had a good prognosis, but they should be followed up regularly. Urinary ultrasound screening for neonates, especially those high-risk neonates with abnormal fetal urinary ultrasound, has important clinical implications for the early detection of CAKUT.

Value of Superb Micro-vascular Imaging in Diagnosing Carotid Artery Vulnerable Plaque / 中国医学科学院学报

Objective To explore the diagnostic value of superb micro-vascular imaging (SMI) for patients with vulnerable plaque of carotid artery. Methods Totally 69 patient with carotid hypoechoic or predominantly hypoechoic plaque (108 plaques),which were identified by conventional ultrasound,underwent SMI and contrast-enhanced ultrasound (CEUS). Based on the scores of CEUS and SMI (0,1,and 2 points),the consistency of SMI and CEUS in detecting plaque neovascularization was assessed. Results SMI could more clearly display the profile and morphology of the plaques than conventional ultrasound. SMI showed that there were neovascularization in 75 plaques,and CEUS showed that there were neovascularization in 76 plaques;the number of scoring consistency in the plaque neovascularization under SMI and CEUS was 90,suggesting these two results were highly consistent (Kappa value=0.748). There were 6 ulcerated carotid plaques detected by SMI,and the same 6 ulcerated carotid plaques were detected by CEUS,showing complete consistency. Of these 108 plaques,55 caused stenosis of the lumen,and SMI showed there was no correlation between plaque neovascularization and stenosis of the lumen caused by plaques (P=0.473). Conclusion SMI can clearly display the morphology and outline of the plaques and the plaque neovascularization. Therefore,it can be used for evaluating plaque vulnerability.

Sonographic features of focal Hashimoto's thyroiditis / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the diagnostic values of gray-scale and color Doppler ultrasound in the diagnosis of focal Hashimoto's thyroiditis (FHT).</p><p><b>METHODS</b>The gray-scale and colour Doppler ultrasound data of 120 patients with histopathologically confirmed FHT were retrospectively studied. The background of thyroid parenchyma was subjectively evaluated as absence or presence of diffuse Hashimoto's thyroiditis. The vascular types of thyroid nodules were determined as follows: hypovascularity, marked internal flow, marked peripheral flow, and focal thyroid inferno.</p><p><b>RESULTS</b>Among all 120 nodules, 71 (59.2%) were located in normal thyroid parenchyma, 49 (40.8%) in the background of diffuse Hashimoto's thyroiditis. In the normal thyroid background, hypoechoic nodules accounted for 85.9% (61/71), and only 14.1% (10/71)nodules were isoechoic or hyperechoic. However, in the background of diffuse Hashimoto's thyroiditis, 40.8% were hypoechoic and 59.2% were isoechoic or hyperechoic. The difference was statistically significant (P<0.001). In terms of the vascular types, the hypovascularity, marked internal flow, marked peripheral flow, and focal thyroid inferno accounted for 45 %, 25.9%, 20.8%, and 8.3%, respectively.</p><p><b>CONCLUSION</b>The "focal inferno" is a relative specific color Doppler feature of FHT.</p>

Ultrasound diagnosis of congenital intrahepatic portosystemic shunt / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the ultrasonographic features of congenital intrahepatic portosystemic venous shunt (CIPSVS) and to assess the clinical value of ultrasonography in the diagnosis of CIPSVS.</p><p><b>METHODS</b>Six cases of CIPSVS diagnosed in our hospital between March 2010 and March 2012 and confirmed by enhanced computed tomography (CT) were retrospectively reviewed. Five of the six cases had follow-up data that was included in the analysis.</p><p><b>RESULTS</b>Among the six CIPSVS cases, only one was classified as Park's type II and the rest were classified as Park's type III. Five cases involved the right lobe of the liver and only one case involved the left lobe. The lesion shapes included cystic, tubular, and irregular with clear contour and appeared to be anechoic on CT scan. The lesions ranged in size from 1.1*0.6 cm to 2.0*1.7 cm. For all cases, the color Doppler ultrasound images showed blood flowing from the portal vein to the hepatic vein, and single-phase spectrum was detected in the diversion channel. The differences observed in level of lesion size and blood flow velocity at the shunt from the time of examinations at diagnosis and subsequent follow-up did not reach statistical significance (P = 0.223 more than 0.05 and P = 0.930 more than 0.05 respectively).</p><p><b>CONCLUSION</b>Although cases of CIPSVS are rare, they share some specific sonographic features that may help in diagnosis. Color Doppler ultrasound findings have high diagnostic accuracy and may represent a preferred modality for follow-up monitoring.</p>

Influence of scald and lipopolysaccharide on gastrointestinal motility / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the pathogenesis of gastrointestinal motility dysfunction as a result of scald and lipopolysaccharide (LPS) challenge in guinea pigs.</p><p><b>METHODS</b>Thirty guinea pigs were enrolled in the study and were randomly divided into 3 groups:i. e. control (n = 10, with intraperitoneal injection of isotonic saline), scald (n = 10, with 30% TBSA deep partial thickness burn) and LPS (n = 10, with intraperitoneal injection of LPS) groups. Thirty minutes after treatment, all animals were gavaged with carbolic ink. The propelled distance of the ink within the gastrointestinal tract was measured. The intestinal tissue was harvested and homogenized, and the contents of CGRP, Na+-K+-ATP enzyme, Mg2+-ATP enzyme, Ca2+-ATP enzyme, Ca2+-Mg2+-ATP enzyme were determined, and the delta phim of haustra coli smooth muscular cell mitochondria was assessed.</p><p><b>RESULTS</b>The propelled distance of the ink in the gastrointestinal tract in scald (53 +/- 9 cm) and LPS (91 +/- 10 cm) groups was obviously shorter than that in control group (142 +/- 11 cm, P < 0.01). Furthermore, the distance in scald group was shorter than that in LPS group (P < 0.01). The CGRP content in scald and LPS groups [52.0 +/- 39.0 microg/L and 20.0 +/- 23.0 microg/L] was obviously higher than that in control group (0.8 +/-2.0 microg/L, P <0.05 or 0.01), especially in scald group ( P < 0.05). The Na+-K+-ATP enzyme, Mg2+-ATP enzyme, Ca2+-ATP enzyme, Ca2+-Mg2+-ATP enzyme and the delta phim in scald and LPS groups were remarkably lower than those in control group (P <0.005), but there was no difference between scald and LPS groups (P > 0.05).</p><p><b>CONCLUSION</b>The gastrointestinal motility of guinea pigs could obviously be inhibited by scald and LPS, especially by scald. LPS might be the key factor to produce change in the membrane potential of mitochondria of intestinal smooth muscle after severe scald.</p>