Analysis of the Causes and Progress in the Treatment of Impaired Maturation of Radio-cephalic Fistula for Haemodialysis / 现代生物医学进展

Radial-cephalic arteriovenous fistula (RCAVF) is considered the first choice for hemodialysis vascular access because of its high patency rate and less complications.But up to 50％ of the fistula can not mature.This is mainly due to persistent low blood flow or difficulty in cannulation can not lead to adequate hemodialysis.Inflow or outflow stenosis,anastomotic stenosis,exceedingly deep location of the vein,flow diversion into accessory veins are the common causes of impaired maturation.In addition,thrombosis is a common of stenosis.Preoperative assessment by physical examination and ultrasound examination of blood vessels,select the appropriate blood vessels for the fistula is of great significance.Choose the appropriate treatment for the cause of maturation disorders.Postoperative aspirin is widely used to prevent thrombosis and reduce the occurrence of stenosis;Surgery has the advantage of bypassing the damaged area but creating a new stoma;in recent years,endovascular technique because of its characteristics of minimally invasive in most of the time is the first choice.In this paper,the definition,etiology,diagnosis and treatment of fistula maturation disorder are reviewed.

Epidemiological characteristics and clinical features of sporadic viral hepatitis E [HEV]

The study aims to analyze the epidemiological characteristics and clinical features of sporadic viral hepatitis E. The 1,000 cases of sporadic viral hepatitis E patients treated in 20 hospitals from May 2013 to May 2016 were selected as research subjects, with their clinical data retrospectively analyzed. [1] Epidemiological characteristics: Seen from the disease time, the 1,000 patients have morbidity throughout the year, but morbidity in hot and rainy summer is significantly higher than other seasons, there exists statistically difference in comparison between the groups [P<0.05]; sporadic viral hepatitis E has no family aggregation; male morbidity is greater than female. In the study, there were male 782 cases, 218 female cases, with male /female ratio at 3.6: 1; morbidity was 13.7% [137/1000] for patients under 18, 62.9% [629/1000] for patients aged 18-60, 23.4% [234/1000] for patients over 60; there were 692 cases of simplex hepatitis E [simplex infection], 308 cases of hepatitis E complicated with chronic liver disease [super infection], of which, complicated viral hepatitis B took up the majority. [2] Clinical features: In the early stage, patients had symptoms of fever, stuffy nose, sore throat; 784 [78.4%] patients had jaundice during illness; 527 [52.7%] patients had loss of appetite, nausea and other gastrointestinal symptoms; ALT, AST of patients with hepatitis E plus posthepatitic cirrhosis were significantly lower than patients with simplex infection [all P<0.01]; total bilirubin in patients over 60 was significantly higher than that of young and middle-aged patients, statistical difference in statistical analysis was [P <0.05]; in the study, 274[27.4%] patients had complications, complication probability of patients aged over 60 was higher than young and middle-aged patients, difference comparison was statistically significant [P<0.05]; complication probability of super infected patients was higher than those with simplex infection [P<0.01]. All the patients underwent liver protection, jaundice removal and other symptomatic treatments, achieving good treatment effect: 315 cases were cured, 678 cases had improved condition, 7 cases died. There exists obvious correlation between morbidity of sporadic viral hepatitis E and season, gender and age; once sicken, one needs to take early symptomatic treatment, to avoid more severe damage to liver function

The clinical analysises of percutaneous mechanical thrombectomy apply to vascular disease / 国际外科学杂志

For recently 30 years,with the progress of science,the development of intracavitary technology has been constantly improved and expanded.Reascularization technology makes the cure of vaso-occlusive disease a great leap.Because of its small trauma,repeatable,high security,near future curative effect,interventional therapy is distinctly superior to the traditional treatment such.Peripheral vascular lumen treatments including the balloon dilatation,stent-assisted angioplasty,catheter guided thrombolysis,and percutaneous mechanical thrombectomy,etc.Although angioplasty has become the best choice but the preferred treatment has limitations,such as for long and severe calcification of arteries occlusion surgery is difficult,immediate and long-term patency rate is low,the postoperative complications is frequent;Used for plaque ulcer and potentially thromboembolic disease,body highly risks of distal embolization;Inherent retraction force for postoperative lumen,intimal inflammation restenosis,stent thrombosis cause problems frequently.However,the percutaneous mechanical thrombectomy system is aimed at solving the clinical problems with good combination of engineering and technology research.The purpose of this paper is to expound the existing mechanical embolus removal system:SilverHawk/TurbjHawk aod Straub Rotarex thrombus,that is to elaborate its development status and clinical analysis.

Preoperative judging of T-staging of rectal cancer by transrectal biplane ultrasound / 中华超声影像学杂志

ObjectiveTo explore the accuracy of judging the T-staging of rectal cancer by biplane transrectal ultrasound.MethodsPathological enteroscopic biopsy was carried out for 197 cases of rectal cancer.Cases of middle and lower rectal cancer without serious obstruction were examined by means of transrectal biplane ultrasound through which to observe the changes of the echoes and to detect the depth of the infiltration in the intestinal walls and the presence of invasions in prostate glands,seminal in male or vesicles,uterine cervix in female.On the basis of the findings,the preoperative tumor staging was made.Postoperatively,the ultrasound results were compared with the pathological examination.Their consistency was evaluated by using Kappa test.ResultsTransrectal biplane ultrasound examination showed the total accuracy rate in T-staging of rectal cancer was as high as 83.8％ with the diagnostic sensitivity rate for T1to T4 as 77.8 ％,73.1％,89.3％ and 94.4％,while its diagnostic specificity rate degree was 97.3％,93.1 ％,85.1 ％,97.8％ respectively,The k -value was 0.732 which suggested that the ultrasound staging was highly consistent with the pathological staging(P＜0.05).ConclusionsTransrectal biplane ultrasound has a great value in the preoperative T-staging of rectal cancer and is helpful in the planning of treatment.

A control study of ultrasound and histology of normal rectal walls / 中华超声影像学杂志

Objective To investigate the ultrasonographic features of normal rectal walls.Methods Ten removed rectal specimens were scanned with high frequency (4-13 MHz) linear array probe to obtain ultrasound images of various layers and having each layer marked,and separated,followed by histological examination respectively.Results Ultrasound demonstrated seven layers of structure which were identified by alternative high and low echoes.From innermost layer towards the outer layers,they were divided as:high-echo acoustic interface,low-echo mucous layer,high-echo sub-mucous layer,low-echo circular muscle layer,high-echo fibrous connective tissue layer,low-echo outer longitudinal muscle layer and high-echo outer membrane layer.All these findings were justified by histological examination.Conclusions High-frequency ultrasound demonstrated 7 layers of echoes in normal rectal walls.This provides imaging basis for diagnosis and judge the invasion degree of rectal cancers.