Influence of Iron Deficiency on the Index of Thalassemia Screening / 中国实验血液学杂志

OBJECTIVE@#To investigate the influence of iron deficiency on the index of thalassemia screening.@*METHODS@#876 blood samples of the couples at childbearing age, who underwent red blood cell analysis, hemoglobin electrophoresis, ferritin and gene diagnosis were selected. The samples were divided into normal, iron deficiency, αthalassemia, α-thalassemia combining with iron deficiency, β-thalassemia and β-thalassemia combining with iron deficiency group. The differences of hematology index and hemolobin value A2 between each groups were analyzed.@*RESULTS@#The value of Hb, MCV, MCH, MCHC in iron deficiency, αthalassemia, α-thalassemia combining with iron deficiency, β-thalassemia and β-thalassemia combining with iron deficiency group all were lower than that of normal group, while the value of RDW-CV was higher, in which the difference between β-thalassemia was the highest. The distribution of HbA2 among each groups was not significantly different expect of β-thalassemia. There was no significant correlation between HbA2 and ferritin level.@*CONCLUSION@#RDW-CV increases in both iron deficiency and thalassemia. Iron deficiency has no significant effect on the level of hemoglobin A2.

The clinical research of high‐frequency contrast‐enhanced ultrasound in guiding peripheral lung consolidation biopsy / 中华超声影像学杂志

To explore the clinical application value of high‐frequency contrast‐enhanced ultrasound in guiding peripheral lung consolidation biopsy . Methods Clinical data of 33 patients with peripheral pulmonary w ho underwent high‐frequency contrast‐enhanced ultrasound biopsy were retrospectively analyzed . According to the pathological results as the gold standard ,the puncture path , needle tip display ,puncture complications and the diagnostic rate of pathological results were described . Results Among the 33 patients ,32 patients had pathological findings ,including 18 malignant lesions ,14 benign lesions ,and 1 non‐effective tissue . ①T he difference between lesion enhancement and peripheral lung tissue enhancement time within 2 .5 s were in 20 patients ( 12 benign ,8 malignant) ,12 patients ( 2 benign ,10 malignant) showed difference greater than 2 .5 s . T here were 19 cases with uniform enhancement ,including 9 benign cases ( 28 .1% ) ,10 malignancy cases ( 31 .3% ) ; 13 cases with uneven enhancement ,including 5 cases with benign ( 15 .6% ) ,8 cases with malignancy ( 25 .0% ) . T he rate of relatively uneven enhancement of malignant lesions was higher ,but the difference was not statistically significant ( P ＝0 .618 ) . ② High‐frequency contrast‐enhanced images were scored at 2 points or more in 28 cases ( 87 .5% ) ,and the high‐frequency contrast‐enhanced ultrasound images were satisfactory . ③Interventional puncture path score was 2 points or more in 29 cases ( 90 .6% ) . ④Puncture needle tip display were scored at 1 point or more in 28 cases ( 87 .5% ) . ⑤A total of 87 needles were punctured ,and 32 cases obtained pathological diagnosis of puncture ( 97 .0% ,32/33) . Conclusions Due to its high spatial resolution ,high‐frequency ultrasound can avoid adjacent tissues and blood vessels by showing the position of the needle tip in real time without the need of puncture frame and multi‐angle needle insertion during operation ,and accurately locate the target with good safety .

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>

A clinical study on multi-disciplinary team and surgery for resectable colorectal cancer with liver metastases / 中华外科杂志

<p><b>OBJECTIVES</b>To analyze the survival outcomes of the surgery for colorectal cancer with liver metastases (CRCLM), and study the mode of multi-disciplinary team (MDT) for CRCLM.</p><p><b>METHODS</b>The retrospective analysis was conducted for 38 patients with CRCLM received MDT management and surgical treatment from January 2009 to August 2011. The peri-operative and survival outcomes of MDT and surgery were evaluated.</p><p><b>RESULTS</b>All the cases met the present criteria of resetability for CRCLM, but only 4 cases (10.5%) met the previous one. Coloproctectomy and hepatectomy were performed in all cases, with 39 colorectal neoplasms and 155 liver lesions removed. One case died of postoperative septic shock. Colorectal and hepatic specific complications were absent in the others patients except one case of biliary leak which was treated with conservative management. Neoadjuvant chemotherapy was arranged in 13 cases. Adjuvant chemotherapy was administered for every patient. After a mean follow-up of (22 ± 10) months according to the finding time of liver metastases, recurrence and metastases were observed in 16 cases and 6 cases died of late-stage cachexia. The 1-, 2- and 3-overall survival rate were 94.4%, 85.3% and 75.8% respectively, and the 1-, 2- and 3-disease-free survival rate were 70.1%, 54.2% and 54.2% respectively.</p><p><b>CONCLUSIONS</b>MDT mode for resectable CRCLM is recommendable. Surgical resection of CRCLM is feasible and safe, which seems to achieve favourable short-middle oncologic outcomes. And long-term survival is expected.</p>

Minimally invasive surgery for resectable colorectal cancer with liver metastases: a prospective study / 中华肝胆外科杂志

Objective To prospective study the use of minimally invasive surgery (MIS) for colorectal cancer with liver metastases (CRCLM) and to analyze the safety and survival outcomes.Methods 31 patients with resectable CRCLM were enrolled into this study from January 2009 to August 2011.Synchronous or metachronous liver metastases were diagnosed in 26 and 5 patients,respectively.The treatment strategy was discussed and decided by a multi disciplinary team which consisted of experienced colorectal surgeons,hepatic surgeons,medical oncologists,radiologists,and pathologists.Treatment included the use of neoadjuvant chemotherapy,one or two-staged surgery,and suitability to use laparoscopic surg(e)ry.Results Coloproctectomy and partial hepatectomy were carried out in all these patients,and every patient received at least one laparoscopic procedure.The operations in cluded: laparoscopic coloproctectomy plus hepatectomy (n=10),laparoscopic coloproctectomy only (n 18) and laparoscopic partial hepatcctomy only (n=3).One-staged coloproctectomy and hepatectomy were performed in 19 patients who presented with synchronous CRCLM.Colorectal and hepatic specific complications,such as anastomotic leak,liver failure,biliary leak,abdominal infection and abdominal bleeding,were not detected in these pati(e)nts.Neoadjuvant chemotherapy was used in 12 patients.Adjuvant chemotherapy was given to every patient.At a mean follow-up of 23.3 months from the diagnosis of liver metastases,the overall survival and disease-free survival were 87.1％ and 71.0％,respectively.Conclusions MIS for resectable CRCLM in carefully selected patients was safe and feasible.A one staged laparoscopic coloproctectomy and partial hepatectomy was possible.The short-middle oncologic outcomes were acceptable,but the long-term survival was still not clear.

The Clinical Value of 64-row Spiral CT in Diagnosing Early Primary Ureteral Carcimoma / 中国医学影像学杂志

Purpose To analyze the 64-row spiral CT manifestations and evaluate the diagnostic value in early primary ureteral carcinoma.Materials and Methods Fifteen cases of early primary ureteral carcinoma proved by surgery and pathology were reviewd.Unenhanced scan,enhanced scan in arterial phase,parenchymal phase,delayed phase and CPR construction were performed in all patients.MIP were performed in 10 cases.Results ① the localization of lesions:7cases were located at the right ureter and 8 cases at the left.2 cases were located at the upper portion of the ureter,6 at mid portion,and 7 at lower portion;② CT manifestations:8 cases showed irregular thickened wall and central lumen stenosis,4 cases eccentric soft tissue mass in lumen and crescent or linear vestigial lumen,3 cases soft tissue density and obsolescent lumen;③the enhanced features:the tumor was demonstrated apparent and uniform enhancement in 13 cases,inhomogeneous enhancement in 2 cases after administration of contrast medium;④ the accompanied signs:proximate renal and ureteral presented distention,dropsy in different degrees,5 cases appeared delayed development.Conclusion 64-row spiral CT volume scan and 3D reconstruction with multiplane and multiorientation,combined with axial enhanced scan,can show lesions dimensionly and increase the dignostic accuracy in early primary ureteral carcinoma,which has an important value.