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Objective:To investigate the predictive effect of intraoperative selective lymph node frozen pathological examination on central lymph node metastasis in thyroid papillary carcinoma (PTC).Methods:A total of 721 PTC patients who underwent primary radical thyroidectomy and central lymph node dissection in Xuanwu Hospital of Capital Medical University from January 2015 to June 2019 were selected. All patients underwent intraoperative selective lymph node frozen pathological examination. According to the paraffin section pathological diagnosis results, there were 449 cases of thyroid micropapillary carcinoma (PTMC) and 272 cases of non-PTMC. The association of the frozen pathological examination results of intraoperative prelaryngeal lymph nodes, anterior tracheal lymph nodes and paratracheal lymph nodes with the pathological results of postoperative central lymph nodes was analyzed in all patients and those with central lymph node positive confirmed by postoperative pathological examination in different groups stratified by tumor long diameter, including 192 cases in PTMC group, 142 cases in long diameter >1 cm and <2 cm group and 55 cases in long diameter ≥2 cm group; postoperative paraffin pathological results were treated as the gold standard. The sensitivity and false negative rate of intraoperative frozen pathological examination in the diagnosis of central lymph node metastasis were calculated.Results:There were 42.8% (192/449) and 72.4% (197/272) of PTMC patients and non-PTMC patients with central lymph node metastasis, respectively. Among 192 PTMC patients with central lymph node metastasis, the sensitivity of prelaryngeal lymph nodes, paratracheal lymph nodes and anterior tracheal lymph nodes was 28.1% (47/167), 61.4% (70/114) and 53.8% (91/169), respectively based on the intraoperative frozen pathological diagnosis. The sensitivity and false negative rate of intraoperative frozen pathological examination in the diagnosis of central lymph node metastasis was 72.4% (139/192) and 27.6% (53/192), respectively. Among 197 non-PTMC patients with central lymph node metastasis, the sensitivity of prelaryngeal lymph nodes, paratracheal lymph nodes and anterior tracheal lymph nodes was 49.7% (82/165), 51.6% (96/186) and 64.7% (112/173), respectively based on the intraoperative frozen pathological results. The sensitivity and false negative rate of intraoperative frozen pathological examination in the diagnosis of central lymph node metastasis was 84.8% (167/197) and 15.2% (30/197), respectively. The sensitivity of intraoperative lymph node frozen pathological results in the diagnosis of central lymph node metastasis for patients with thyroid capsule involvement in PTMC group, long diameter > 1 cm and < 2 cm group and long diameter ≥ 2 cm group was 81.7% (116/142), 81.7% (103/126) and 92.2% (47/51), respectively.Conclusions:Cervical central lymph node metastasis of PTC is common. Intraoperative frozen pathological examination of prelaryngeal lymph nodes, anterior tracheal lymph nodes and paratracheal lymph nodes can effectively predict whether the central lymph nodes are involved, and this hint is more obvious when the tumor long diameter is more than 2 cm and the thyroid capsule is involved.
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BACKGROUND: Osteosarcoma is the most common primary bone-derived malignancy in children and adolescents. The prognosis of osteosarcoma patients has hardly improved over the past 30 years. It is urgent to develop new strategies and innovative therapies to further improve the survival rate of osteosarcoma patients. OBJECTIVE: To explain the latest advances in molecular mechanisms and signaling networks that contribute to the progression and metastasis of osteosarcoma, and provide a theoretical basis for the treatment of osteosarcoma. METHODS: The “osteosarcoma, signaling pathway, prognosis, metastasis, drug resistance, Notch, Wnt/β-catenin, Hedgehog, PI3K/Akt/mTOR, BMPs” were as keywords to search the articles in the CNKI and PubMed databases published from February 1999 to February 2019. Totally 586 related articles were retrieved. After reading the title and abstract, irrelevant articles were excluded based on exclusion criteria, and finally 40 eligible articles were included for review. RESULTS AND CONCLUSION: Signaling pathways are critical in the regulation of osteosarcoma formation and proliferation. Studies have found that Notch, Wnt/β-catenin, Hedgehog, PI3K/Akt/mTOR and BMP signaling pathways are expressed in osteosarcoma and stem cells, which have an important impact on the occurrence and development of osteosarcoma.
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Objective To measure and analyze cardiac ventricular sizes of acute pulmonary embolism patients,and compared with normal group,to investigate the morphological changes of heart in patients with acute pulmonary embolism.Methods 75 patients with acute pulmonary embolism were analyzed retrospectively and were divided into two groups according to the score of embolism index:more than or equal to 50％ (group c,33 cases) and less than 50％ (group b,42cases) and compared with normal group (group a,56 cases) to analyze the changes of cardiac ventricular transversal diameter(LR) and anteroposterior diameter (AP).Results The group c compared with group a and b,the right ventricular LR and AP,and the right atrium LR increased significantly (P＜0.05),the left ventricular LR decreased significantly (P＜0.05).The group b compared with the group a,the right ventricular LR and the right atrium AP increased significantly (P＜0.05),the left atrium LR decreased significantly (P＜0.05).The left atrial AP,group b was larger than that of group a and group c (P＜0.05).The left ventricular AP,there was no significant difference between the three groups.The atrial ratio (RA/LA) and the ventricle ratio (RV/LV)of the three groups were significantly different (P＜0.05).According to the product of two lines of the same heart cavity (RL × AP),compared with group a and b,the left atrium and ventricle of group c decreased (P＜0.05),the right atrium and ventricle enlarged (P＜0.05).Compared with group a,the left ventricular angle of group c decreased significantly (88.97±5.47 vs 97.91±7.66,P＜0.001),there was no significant difference between the group b and c (P＞0.05).After the treatment of acute pulmonary embolism,the right ventricular RL × AP is significantly reduced(4 209.57±844.63 vs 5 090.58±1312.69,P=-0.002),the ventricle ratio (RV/LV) is significantly reduced(0.80±0.13 vs 0.93±-0.19,P=0.003.Conclusions The size and shape of heart cavity varied with different pulmonary embolism index,and we can make preliminary observation and evaluate treatment efficacy by using chest CT scan.
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Aim To investigate the effect of M3 mAChR on the proliferation and migration of NSCLC and the molecular mechanisms. Methods CCK-8 as-say,Wound-healing assay and Transwell invasion as-saywere used to determine the cell proliferation,migra-tion and invasion. Calcium imaging was used to identi-fy the M3 mAChR subtype mediating carbachol-in-duced increase in intracellular calcium. Western blot was used to determine the protein level of proliferation, migration and cell cycle related signaling molecules. Results Following the treatment with M3R antagonists 1. 25 ~ 80 μmol · L - 1 for 48 h,the proliferation of NSCLC cells was inhibited,the inhibitory effect:R2-8018 > Darifenacin,H1299 > H460. After the treat-ment with R2-8018,the migration and invasion of H1299 significantly declined. Western blot showed that the protein level of p-Akt,p-GSK3β,cyclinD1 de-clined significantly with the increase of time and that the protein level of p21 increased. Conclusion M3R antagonists induce cell cycle arrest by suppressing the activation of Akt,down-regulating GSK3β and cy-clinD1,and up-regulating p21,then inhibiting the proliferation of NSCLC cells. It also inhibits the inva-sion and migration by down-regulating MMP-2.
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BACKGROUND: Expansive pedicle screws have been found to have strong resistance to rotation, prevent screw loosening and pulling out, and maintain the stability and physiological curvature of lumbar vertebrae, so it provides a secure and stable environment for long-tem intervertebral fusion.OBJECTIVE: To investigate the clinical efficacy of the expandable versus conventional pedicle screws in the treatment of osteoporotic lumbar spondylolisthesis.METHODS: A total of 67 cases of osteoporotic lumbar spondylolisthesis were randomized into three groups, and then treated with conservative treatment (n=12), expansive pedicle screws (n=20), and common pedicle screws (n=35),respectively. The Japanese Orthopaedic Association and Visual Analogue Scale scores as well as radiological data were obtained immediately and 1 week after admission, 6 and 12 months after discharge. The stability of the screw and spinal fusion were evaluated, and the spondylolisthesis was assessed according to Meyerding system.RESULTS AND CONCLUSION: (1) The improvement rate of Japanese Orthopaedic Association scores at the last follow-up showed no significant difference between expansive and common groups (P=1.00), and the improvement rate in the expansive and common groups was significantly higher than that in the conservative group (P < 0.05). (2) The Visual Analogue Scale scores in the expansive and common groups were significantly decreased, and the scores did not differ significantly between two groups (P > 0.05); the scores in the conservative group changed irregularly. (3) The reduction rate of spondylolisthesis in the expansive group was significantly higher than that in the common group (P < 0.01). (4) The spinal fusion score at 24 months postoperatively in the expansive group was significantly higher than that in the common group (P=0.035). (5) For osteoporotic patients with lumbar spondylolisthesis, the expansive pedicle screws are much better than the common pedicle screws in the spondylolisthesis reduction, fusion rate of bone graft,screw stability; therefore, it is a safer and more effective method.
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BACKGROUND: Unicompartment knee replacement is more popular for small trauma, rapid recovery, low less complications and almost normal knee mechanics, and has been used to repair unicompartmental knee diseases. At abroad, unicompartmental knee arthroplasty for advanced spontaneous osteonecrosis of knee (SONK) has obtained satisfactory outcomes, but its long-term efficacy and safety are not known in China. OBJECTIVE: To explore the short-term effectiveness of unicompartmental knee arthroplasty for advanced SONK. METHODS: Clinical data of 12 SONK patients (12 knees) admitted between January and August 2015 were analyzed retrospectively. Unicompartmental knee arthroplasty was operated by the same surgical team using the 3rdgeneration of Oxford?Unicompartmental Knee. The Visual Analogue Scale, femorotibial angle, range of motion of the knee and Hospital for Special Surgery scores were used to evaluate the curative efficacy at 3, 6, 12, and 18 months postoperatively. RESULTS AND CONCLUSION: (1) All patients were followed up for 12-18 months. The incision in all patients achieved primary union, and no infection, lower limb venous thrombosis or fracture occurred. (2) At the end of follow-up, the Visual Analogue Scale scores were significantly reduced from preoperative (6.67±0.78) to (1.75±0.97); the Hospital for Special Surgery scores were significantly increased from preoperative (63.92±7.27) to (91.67±2.87); the femorotibial angle changed from preoperative (178.28±3.38)° to (176.82±2.37)°(All P < 0.05). But the range of motion of the knee joint did not differ significantly before and after surgery. (3) That is to say, unicompartmental knee arthroplasty obtains satisfactory short-term efficacy in the treatment of advanced SONK.
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BACKGROUND: Self-healing ability of the posterior cruciate ligament is poor, and the degradation and synthesis of extracellular matrix often follow the ligament repair. The matrix metalloproteinase family plays a critical role in the dynamic equilibrium between the matrix degradation and synthesis. OBJECTIVE: To investigate the effect of arthroscopic reconstruction of the posterior cruciate ligament, and to study its correlation with matrix metalloproteinase 2 level. METHODS: Sixty patients with posterior cruciate ligament rupture were studied, including 37 cases of autologous reconstruction and 13 cases of allogeneic reconstruction. Ligament and synovial cells from traumatic amputation patients with no ligament injury in the corresponding period were collected. Lysholm and Tegner scores were detected before and after operation. The results of postoperative drawer test were analyzed. The tibial displacement of the posterior cruciate ligament after autologous reconstruction and allogeneic reconstruction was compared. The posterior cruciate ligament cells were cultured alone or co-cultured with synovial cells, and then the level of matrix metalloproteinase 2 protein was detected. In addition, operation time, incision length, postoperative fever time and gender differences were also detected and compared.RESULTS AND CONCLUSION: Tibial displacement, irrespective of genders, was higher in the allogeneic reconstruction group than the autologous reconstruction group, while there were no significant differences in the posterior drawer test between the two reconstruction groups as well as between males and females. Postoperative Lysholm and Tegner scores were both improved significantly (P < 0.01). As time went by, the level of matrix metalloproteinase 2 had an increasing trend in the posterior cruciate ligament cells cultured alone or co-cultured with synovial cells, but the level in the co-culture group was higher than that in the single culture group. For both male and female, the autologous reconstruction group showed a longer operative time (P < 0.05 or 0.01) and a longer incision length (P < 0.01), as compared with the allogeneic reconstruction group, while the time of fever was significantly longer in the allogeneic reconstruction group (P < 0.01). Results from the last follow-up show that the autologous reconstruction is better than the allogeneic reconstruction to restore the stability of posterior cruciate ligament and shorten fever time, but longer operative time and surgical incision as well as increased level of matrix metalloproteinase 2 cannot be ignored.
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Objective To design and develop a multi-modality medical image fusion and evaluation simulation system to eliminate the deficiencies of the images by different technologies.Methods The system was developed with MATLAB 2014a development platform as well as MATLAB graphical user interface and image processing toolbox.Results Common methods were realized of multi-modality medical images,and the evaluation on seven objective indicators was implemented such as entropy,mutual information,cross entropy,mean,standard deviation and etc.Conclusion The system behaves well in interactivity,practicality and extensibility,and is of great significance for clinical diagnosis as well as teaching medical image processing in specialties of biomedical engineering,medical image technology and etc.[Chinese Medical Equipment
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Objective To investigate the expression profiles and chromosome distribution characteristics of miRNA in bone marrow samples between the patients with adult B-cell acute lymphoblastic leukemia (B-ALL) and their controls. Methods Illumina sequencing technology was applied to perform global miRNA expression analysis and chromosome distribution analysis in the bone marrow samples of 15 adult B-ALL patients relative to a control group of 10 patients without hematologic malignancies. Then, qPCR was carried out to validate the reliability of the se-quencing data. Results In total,291 differentially expressed miRNAs including 168 up-regulated and 123 down-regulated miRNAs were indentified in adult B-ALL patients as compared with their controls. Despite the distribution of miRNA genes in chromosome was similar in both samples, the distribution of miRNA expression abundance in chromosome show obvious differences. B-ALL group was mainly located in the chromosome 1, 2, 5 and 9, while the control group was mainly located in the chromosome 3,7,9,17 and X. Conclusions The altered expression profile of miRNA in bone marrow samples of adult B-ALL patients implies that aberrantly expressed miRNAs maybe plays roles in the occurrence and development of B-ALL.
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Objective To observe the effect ofXing Nao Kai Qiao (awakening brain and opening orifice) needling method on the cognitive and motor function of patients in acute stage of cerebral infarction.Method Sixty-four patients in acute stage of cerebra infarction were recruited and randomized into a trial group and a control group, 32 cases in each group. The control group was intervened by Edaravone 30 mg plus Fibrinogenase injection 200 U mixed in 500 mL 0.9% NaCl via intravenous drip, once a day. The trial group was byXing Nao Kai Qiao needling method in addition to the intervention given to the control group, once a day, 5 times a week. The two groups were both given 2-week successive treatment. At the end of the intervention, clinical efficacy, cognitive function, motor function, nervous function, serum C-reactive protein and NO levels, and adverse reactions of the two groups were compared.Result After the treatment, the Chinese Stroke Scale (CSS) score dropped significantly, Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) score, Barthel Index (BI) score and motor function score of both upper and lower limbs increased significantly in both groups (P<0.05); the total effective rate of the trial group was significantly higher than that of the control group (P<0.05); the CSS score was lower, and LOTCA score, BI score, and motor function scores of both upper and lower limbs were higher in the trial group compared with those in the control group, and the differences were statistically significant (P<0.05); on the 1st, 3rd, 7th and 14th day after the intervention, the serum CRP and NO levels were significantly lower in the trial group compared with those in the control group (P<0.05). There was no significant difference in comparing the adverse reaction incidence between the two groups (P>0.05).Conclusion Xing Nao Kai Qiao needling method can produce a significant efficacy in treating patients in acute stage of cerebral infarction, and it can improve the cognitive, motor and nervous functions with high security.
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BACKGROUND: Self-healing ability of the posterior cruciate ligament is poor, and the degradation and synthesis of extracellular matrix often follow the ligament repair. The matrix metalloproteinase family plays a critical role in the dynamic equilibrium between the matrix degradation and synthesis. OBJECTIVE: To investigate the effect of arthroscopic reconstruction of the posterior cruciate ligament, and to study its correlation with matrix metalloproteinase 2 level. METHODS: Sixty patients with posterior cruciate ligament rupture were studied, including 37 cases of autologous reconstruction and 13 cases of allogeneic reconstruction. Ligament and synovial cells from traumatic amputation patients with no ligament injury in the corresponding period were collected. Lysholm and Tegner scores were detected before and after operation. The results of postoperative drawer test were analyzed. The tibial displacement of the posterior cruciate ligament after autologous reconstruction and allogeneic reconstruction was compared. The posterior cruciate ligament cells were cultured alone or co-cultured with synovial cells, and then the level of matrix metalloproteinase 2 protein was detected. In addition, operation time, incision length, postoperative fever time and gender differences were also detected and compared.RESULTS AND CONCLUSION: Tibial displacement, irrespective of genders, was higher in the allogeneic reconstruction group than the autologous reconstruction group, while there were no significant differences in the posterior drawer test between the two reconstruction groups as well as between males and females. Postoperative Lysholm and Tegner scores were both improved significantly (P < 0.01). As time went by, the level of matrix metalloproteinase 2 had an increasing trend in the posterior cruciate ligament cells cultured alone or co-cultured with synovial cells, but the level in the co-culture group was higher than that in the single culture group. For both male and female, the autologous reconstruction group showed a longer operative time (P < 0.05 or 0.01) and a longer incision length (P < 0.01), as compared with the allogeneic reconstruction group, while the time of fever was significantly longer in the allogeneic reconstruction group (P < 0.01). Results from the last follow-up show that the autologous reconstruction is better than the allogeneic reconstruction to restore the stability of posterior cruciate ligament and shorten fever time, but longer operative time and surgical incision as well as increased level of matrix metalloproteinase 2 cannot be ignored.
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Objective To design and develop a multi-modality medical image fusion and evaluation simulation system to eliminate the deficiencies of the images by different technologies.Methods The system was developed with MATLAB 2014a development platform as well as MATLAB graphical user interface and image processing toolbox.Results Common methods were realized of multi-modality medical images,and the evaluation on seven objective indicators was implemented such as entropy,mutual information,cross entropy,mean,standard deviation and etc.Conclusion The system behaves well in interactivity,practicality and extensibility,and is of great significance for clinical diagnosis as well as teaching medical image processing in specialties of biomedical engineering,medical image technology and etc.[Chinese Medical Equipment
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Objective To investigate the expression profiles and chromosome distribution characteristics of miRNA in bone marrow samples between the patients with adult B-cell acute lymphoblastic leukemia (B-ALL) and their controls. Methods Illumina sequencing technology was applied to perform global miRNA expression analysis and chromosome distribution analysis in the bone marrow samples of 15 adult B-ALL patients relative to a control group of 10 patients without hematologic malignancies. Then, qPCR was carried out to validate the reliability of the se-quencing data. Results In total,291 differentially expressed miRNAs including 168 up-regulated and 123 down-regulated miRNAs were indentified in adult B-ALL patients as compared with their controls. Despite the distribution of miRNA genes in chromosome was similar in both samples, the distribution of miRNA expression abundance in chromosome show obvious differences. B-ALL group was mainly located in the chromosome 1, 2, 5 and 9, while the control group was mainly located in the chromosome 3,7,9,17 and X. Conclusions The altered expression profile of miRNA in bone marrow samples of adult B-ALL patients implies that aberrantly expressed miRNAs maybe plays roles in the occurrence and development of B-ALL.
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Objective To observe the effect ofXing Nao Kai Qiao (awakening brain and opening orifice) needling method on the cognitive and motor function of patients in acute stage of cerebral infarction.Method Sixty-four patients in acute stage of cerebra infarction were recruited and randomized into a trial group and a control group, 32 cases in each group. The control group was intervened by Edaravone 30 mg plus Fibrinogenase injection 200 U mixed in 500 mL 0.9% NaCl via intravenous drip, once a day. The trial group was byXing Nao Kai Qiao needling method in addition to the intervention given to the control group, once a day, 5 times a week. The two groups were both given 2-week successive treatment. At the end of the intervention, clinical efficacy, cognitive function, motor function, nervous function, serum C-reactive protein and NO levels, and adverse reactions of the two groups were compared.Result After the treatment, the Chinese Stroke Scale (CSS) score dropped significantly, Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) score, Barthel Index (BI) score and motor function score of both upper and lower limbs increased significantly in both groups (P<0.05); the total effective rate of the trial group was significantly higher than that of the control group (P<0.05); the CSS score was lower, and LOTCA score, BI score, and motor function scores of both upper and lower limbs were higher in the trial group compared with those in the control group, and the differences were statistically significant (P<0.05); on the 1st, 3rd, 7th and 14th day after the intervention, the serum CRP and NO levels were significantly lower in the trial group compared with those in the control group (P<0.05). There was no significant difference in comparing the adverse reaction incidence between the two groups (P>0.05).Conclusion Xing Nao Kai Qiao needling method can produce a significant efficacy in treating patients in acute stage of cerebral infarction, and it can improve the cognitive, motor and nervous functions with high security.
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Objective To examine the clinical effect and learning curve of endoscopic thyroidectomy via chest-areolar approach in the treatment of benign thyroid nodules. Methods From January 2012 to May 2016,49 patients underwent endoscopic thyroidectomies via chest-areolar approach in Xuanwu Hospital ,Capital medical university. The clinical characteristics ,prognosis and operation time were retrospectively analyzed. The patients were divided into 9 groups according to the surgical sequence ,and the learning curves were analyzed by using moving average method. Results 49 endoscopic thyroidectomies via chest-areolar approach were performed successfully. The average size of the nodules was(2.80 ± 0.62)cm. 10 patients underwent bilateral thyroidectomy and 39 underwent unilateral thyroidectomy. The average operation time was(157.49 ± 21.23)min. 2 cases received re-operation due to postoperative pathology of malignancy. There were no postoperative recurrent laryngeal nerve injuries. 11 patients suffered from asymptomatic hypocalcemia with parathyroid hormone in the normal range. All of the patients were satisfied with the cosmetic results. The learning curves indicated that 35 endoscopic thyroidectomies were needed to be performed in the early study stage. Conclusions For surgeons with experience of conventional thyroidectomies,endoscopic thyroidectomy via chest-areolar approach is feasible and safe for selected patients. There is a significant learning curve in the application of endoscopic thyroidectomy. In the early study stage of endo-scopic thyroidectomy,35 cases are basically required for beginning surgeons to practice the surgical operation.
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[Objective]To establish a reliable and accurate preimplantation genetic diagnosis (PGD)method using multiple dis?placement amplification (MDA), which can be applied to the diagnosis of X-linked severe combined immunodeficiency disease (X-SCID).[Methods]Haplotype analysis for the X-SCID family was performedusing five short tandem repeats (STR) markers flanking the both sides of the interleukin-2 (IL-2) receptor gamma chain (IL2RG) gene. MDA technique was used for single-cell whole genomic amplification. The products were used as template in polymerase chain reaction (PCR) of informative STR markers found by linkage analysis for haplotype analysis as well as sequencing of the IL2RG gene exon 5.The amelogenin (AMEL) locus was used to do sex diag?nosis.[Results]Linked analysis revealed 3 STR markers were informative. The method was evaluated with 10 single lymphocytes and 10 single blastomeres. MDA was successful in all single cell. The detection efficiency of gene sequencing of pathogenic IL 2RG exon5 was 100%. The PCR efficiency of 3 STR informative markers and AMEL was 96.3%(77/80)and the average allele drop-out (ADO) rate was 11.5%(7/61). A cycle of PGD was performed on the family, and seven embryos were diagnosed, two of which were normal embry?os. Twin pregnancy occurred after transplantation which were given a healthy baby boy and a healthy baby girl.[Conclusion]In this study, multiple displacement amplification combined with specific amplification/sequencing of pathogenic gene and haplotype analysis in the single cell level of X-linked severe combined immunodeficiency disease were performed. The protocol can avoid misdiagnosis caused by contamination and ADO, and improve the diagnostic efficiency of PGD.
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To apply the ultrasonic 3D reconstruction method to measure the anatomic image data of lacrimal sac in the normal adult Chinese population, providing imaging anatomical basis for the clinical diagnosis and treatment of lacrimal duct diseases. 80 volunteers without lacrimal duct diseases were enrolled. The GE Voluson E8 ultrasonic diagnostic apparatus was used, with gynecological intracavitary probe (frequency: 5 ~ 12MHz) for the examination and measurement. Each datum was repeated three times for the average value. Among the 80 eyes, the lacrimal sacs of 74 eyes exhibited the clear imaging, with the imaging rate as 92.5 %. the vertical diameter of lacrimal sac cavity (LSC): 13.3±2.2 mm; anteroposterior diameter: 6.0±1.1 mm; trans diameter: 4.9±0.9 mm; the vertical distance from the sac cavity top to the skin surface: 6.3±0.12 mm, the vertical distance from the sac cavity bottom to the skin surface: 6.5±0.11 mm; the distance from the angular artery to the medial canthus: 7.8±0.05 mm; the vertical distance from the angular artery to the skin surface: 7.7±0.08 mm. The lacrimal sac and angular artery in the adults could be shown clearly in ultrasonic 3D reconstruction, the accumulated anatomical parameters could provide the instructive meanings towards the clinical diagnosis and treatment of lacrimal diseases.
El objetivo de este estudio consistió en aplicar el método de reconstrucción 3D de ultrasonidos para medir los datos de las imágenes anatómicas del saco lagrimal en una población china adulta normal, proporcionando imágenes con base anatómica para el diagnóstico clínico y el tratamiento de las enfermedades de los conductos lagrimales. La muestra consistió en 80 voluntarios sin enfermedades de los conductos lagrimales. Se utilizó el aparato de ultrasonido GE Voluson E8, con una sonda intracavitaria ginecológica (frecuencia: 5 ~ 12 MHz) para realizar el examen y la medición. Cada dato se repitió tres veces para obtener el valor medio. De los 80 ojos, los sacos lagrimales de 74 ojos mostraron una imagen clara, siendo la tasa de formación de imágenes del 92,5 %. Se realizaron mediciones: diámetro vertical de la cavidad del saco lagrimal (LSC): 13,3 ± 2,2 mm; diámetro anteroposterior: 6,0 ± 1,1 mm; diámetro transversal: 4,9 ± 0,9 mm; distancia vertical desde la porción superior de la cavidad del saco lagrimal hasta la superficie de la piel: 6,3 ± 0,12 mm, distancia vertical desde el fondo de la cavidad del saco lagrimal hasta la superficie de la piel: 6,5 ± 0,11 mm; distancia desde la arteria angular al canto medial: 7,8 ± 0,05 mm; distancia vertical desde la arteria angular a la superficie de la piel: 7,7 ± 0,08 mm. El saco lagrimal y la arteria angular en los adultos se podría demostrar claramente en la reconstrucción 3D con ultrasonido. Los parámetros anatómicos acumulados podrían ser de significativo valor para un certero diagnóstico clínico y tratamiento de enfermedades de los sacos lagrimales.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Imaging, Three-Dimensional , Nasolacrimal Duct/anatomy & histology , Nasolacrimal Duct/diagnostic imaging , UltrasonicsABSTRACT
Purpose: To study the microsurgical anatomy of the lacrimal drainage system and to provide anatomical evidence for transnasal endoscopic lacrimal drainage system bypass surgery by autogenous tissue grafting. Materials and Methods: A total of 20 Chinese adult cadaveric heads in 10% formaldehyde, comprising 40 lacrimal ducts were used. The middle third section of the specimens were examined for the following features: the thickness of the lacrimal fossa at the anterior lacrimal crest, vertical middle line, and posterior lacrimal crest; the cross section of the upper opening, middle part, and lower opening of the nasolacrimal canal; the horizontal, 30° oblique, and 45° oblique distances from the lacrimal caruncle to the nasal cavity; the distance from the lacrimal caruncle to the upper opening of the nasolacrimal duct; and the included angle between the lacrimal caruncle–nasolacrimal duct upper opening junction and Aeby’s plane. Results: The middle third of the anterior lacrimal crest was significantly thicker than the vertical middle line and the posterior lacrimal crest (P > 0.05). The horizontal distance, 30° oblique distance, and 45° oblique distance from the lacrimal caruncle to the nasal cavity exhibited no significant differences (P > 0.05). The included angle between the lacrimal caruncle and the lateral wall middle point of the superior opening line of the nasolacrimal duct and Aeby’s plane was average (49.9° ± 1.8°). Conclusion: The creation of the bony tunnel should start from the middle or posterior middle part of the lacrimal fossa, extending toward the anterior inferior region with an optimal downward oblique angle of 45°.
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Objective To explore the extent of axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes.Methods In this series,95 patients underwent complete axillary lymph node dissection (CALND) following positive sentinel lymph nodes identified and 97 patients underwent partial axillary lymph node dissection (PALND) at the absence of positive sentinel lymph nodes.The influence of different extent of axillary lymph node dissection was evaluated.Results The positive rate of level(Ⅰ + Ⅱ) non-sentinel lymph nodes (NSLN) and level Ⅲ lymph nodes was 68.4％ and 29.5％,respectively,in CALND group.In PALND situation,57.9％ CALND cases would have changed pathologic stage from pN1 to pN2 or pN3.But with level Ⅲ lymph node dissection followed PALND,only 2.1％ cases had changed pathologic stage from pN2 to pN3.Multivariate logistic regression showed that the number of positive SLNs (OR =2.157) and positive rate of SLNs (OR =10.374) were risk factors for having positive level Ⅲ lymph nodes.CALND needed longer operation time and larger postoperative drainage volume.Conclusions In cases of breast cancer with ≥ 3 positive sentinel lymph nodes,complete axillary lymph node dissection should be considered.
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Objective To investigate the diagnosis and treatment of idiopathicgranulomatous mastitis.MethodsThis study was to retrospectively review the clinical presentation,radiological investigation,histopathological features,treatment and outcome of idiopatbic granulomatoos mastitis of women presenting to Xuanwu Hospital between January 2002 and June 2010.ResultsTwenty-four patients with a mean age of 34.5 years presented with a diagnosis of idiopathic granulomatous mastitis.Patients presented with a palpable breast lump,breast abscess,fistula formation in different periods of the disease; the role of radiological imagings was found to be limited in differentiating idiopathic granulomatous mastitis from other inflammatory and maliguant conditions of the breast.All patients underwent a surgical procedure as the main treatment; in the form of excision or incision and drainage of the breast lesions. Mean follow-up was 47.38 ( range 6-96 ) months with recurrence in 3(12.5％) patients.ConclusionsIdiopathic granulomatous mastitis presents clinically with a palpable breast lump.The diagnosis is often only made histopathologically after surgical excision or core biopsy.Wide excision of the lesions or incision and drainage of the lesion are the main treatment modalities.