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@#Objective To summarize our experience in the treatment of esophageal foreign bodies. Methods A retrospective analysis of 149 patients of esophageal foreign bodies in the Second Affiliated Hospital of Air Force Military Medical University from December 2011 to May 2019 was carried out, including 75 (50.3%) females and 74 (49.7%) males with an average age of 57 (2-85) years. Results There were 146 patients confirmed by endoscopy, and 3 patients were not found foreign body. Among the confirmed patients, 127 patients were removed by gastroscope and 19 patients were treated by operation. Esophageal foreign bodies are mainly related to the types of food. Jujube seed is the most common food foreign body in the northwest China. The injury rate of mucosal was 47.54% within 48 hours. The complication rate of taking out the foreign body after 48 hours was 100.0%. The success rate by endoscopy decreased (P=0.005), if the foreign body combined perforation. There was no statistical difference between the neck and other parts when using ultra-fine gastroscope (P=0.157). Conclusion The sharper the foreign body is, the easier the perforation is. The earlier the foreign body is removed, the less complications are. The size of the foreign body determines the difficulty of endoscopic removal. Gastroscopy is the first choice for diagnosis and treatment, especially ultra-fine gastroscopy, and the foreign bodies that cannot be removed by endoscopy need surgical treatment.
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BACKGROUND@#Electromagnetic navigation bronchoscopy is a tool that can accurately navigation peripheral lung lesions. Because of electromagnetic navigation bronchoscopy (ENB) is too expensive, it has not been widely used in China. It is urgent for us to summarize experience in clinical application, especially in the diagnosis of pulmonary nodules.@*METHODS@#The clinical data of patients with pulmonary peripheral lesions (PPLs) in our department undergoing ENB biopsy between July 2017 and December 2018 were retrospectively analyzed.@*RESULTS@#There were 18 patients with 21 PPLs (10 males and 8 females). Among them, 11 patients got the final pathological diagnosis, 8 cases were diagnosed with adenocarcinoma lung cancer, 1 case was diagnosed with tuberculosis and 2 cases were diagnosed with small cell lung cancer. The positive rate of diagnosis was 61.1%. The sensitivity was 73.3%. The positive diagnosis rate is related to the size of the lesion, the positive diagnosis rate for lesions >2 cm is 100.0% (P=0.04).@*CONCLUSIONS@#Electromagnetic navigation bronchoscope is safe and effective in clinic. It has a high positive rate for the diagnosis of peripheral lung lesions larger than 2 cm, ENB has broad clinical application prospects.
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Objective To investigate the clinical value of real-time shear wave elastography( SWE) in early diagnosis of diabetic nephropathy ( DN ) . Methods One hundred and fifty-five patients with type 2 diabetes mellitus (DM) in our hospital were selected as DN group and 54 healthy volunteers with matched age-sex were selected as control group . According to the criteria of Mogensen staging ,patients of DN group were divided into 3 subgroups according to urine protein/creatinine ( ACR) :group A ( DM or DN Ⅰ ,Ⅱ ) , ACR＜30 mg/g ;group B ( DN Ⅲ ) ,ACR 30 －300 mg/g ;group C ( DN Ⅳ ,Ⅴ ) ,ACR＞ 300 mg/g . All subjects were examined by SWE technique to detect the maximum ,mean and minimum Young′s modulus values ( Emax ,Emean ,Emin) of the middle of left renal parenchyma ,the values of Young′s modulus in the control group and DN patients were compared . The relationship between Young′s modulus and ACR in patients with DN was analyzed . Results The Emax ,Emean and Emin in DN patients were all greater than those in control group ( P ＜0 .05) . In group A ,B and C ,Emax ,Emean and Emin gradually increased ( P＜0 .05) . Spearman correlation analysis showed that there was a positive correlation between Young′s modulus and ACR in patients with DN ( r ＝ 0 .817 ,0 .764 ,0 .609 ;all P＝ 0 .000) . ROC curve analysis showed that the area under the curve of Emax diagnosis DN Ⅲ stage was 0 .810 ,the cut-point value was 6 .65 kPa ,the sensitivity was 79 .0% ,and the specificity was 81 .7% ;the area under the curve of Emean diagnosis DN Ⅲ stage was 0 .785 ,and the cut-off value was 3 .69 kPa ,sensitivity 62 .8% ,specificity 78 .3% . Conclusions SWE technique can quantitatively analyze renal parenchyma hardness in patients with different stages of DN ,which may provide new diagnostic information for early diagnosis of DN .