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@#【Objective】To compare the imaging features and early diagnostic value of high frequency color Doppler ultrasonography and X- ray mammography in patients with breast carcinoma in situ. 【Methods】 The clinical data of 55 patients with breast carcinoma in situ confirmed by operation and pathology were collected and analyzed retrospectively ， including high frequency color Doppler ultrasonography and X-ray mammography.【Results】Among 55 cases，28 cases were diagnosed as breast carcinoma in situ by high frequency color Doppler ultrasonography ，with the diagnostic accuracy rate of 50.9%；39 cases were diagnosed as breast carcinoma in situ by X-ray mammography，with the diagnostic accuracy rate of 70.9% . Statistical results showed that the diagnostic accuracy of mammography for breast carcinoma in situ was significantly higher than that of high frequency color Doppler ultrasonography（P=0.049）. The diagnostic accuracy of X- ray mammography was 67.3% and that of high frequency color Doppler ultrasonography was 47.3%（P=0.034）. 43 cases of breast carcinoma in situ were diagnosed by color Doppler ultrasonography and X-ray mammography ，and the diagnostic accuracy was 78.2% ，which increased significantly. 【Conclusions】 X- ray mammography is superior to high- frequency color Doppler ultrasonography in the early diagnosis of breast carcinoma in situ. The combination of the two imaging methods can play a complementary role in improving the accuracy of diagnosis of breast carcinoma in situ and reducing the rate of missed diagnosis.
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Objective To evaluate the effect of intervention on factors influencing the health service utility regarding Maternal and Child Health (MCH)under the 'Qinba Health Project' in Sichuan province. Methods 15 towns in 5 programmed counties were selected, using the method of 'random layer sampling' to be the trial group. With similar MCH status and comparable to the trial group, another 9 towns in 3 non-programmed counties were chosen as the control group, using the same sampling method. Indicators on MCH service utility were compared with that in the control group, and the influencing factors of MCH service utility analyzed by logistic model. Results The main characteristics of the two groups were quite similar at the baseline study, with the average annual family incomes and MCH service per 1000 people. Annual input on MCH services from the government had an distinct increase. The average annual rates of increase regarding the indictors as clean delivery, hospitalized delivery, systematic care on maternal and children, maternal and infant mortality rates were: 1.95%, 9.34%, 4.82%, 3.04%, -2.67%, -13.84% (P<0.02) through χ2 trend tests. In the trial group, the changes seen in the 6 indicators were better in the control group than in the control group(P<0.05). Data from the logistic regression model showed that the major influencing factors on the use of hospitalized delivery service were: age of the pregnant woman, average annual income of the family, health insurance status, number of pre-delivery visits, whether on poverty alleviate program, and on knowledge of MCH. Conclusion The intervention project in this programmed area seemed effective and better than the non-programmed area, through an eight-year observation.
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<p><b>OBJECTIVE</b>To explore the treatment of cervical tracheoesophageal fistula (TEF) with complicated or remnant laryngotracheal stenosis (LTS) and anterior neck defect (AND).</p><p><b>METHODS</b>From 1980 to 2007, 14 patients were diagnosed as TEF. Among them, 9 patients had complicated or remnant LTS, 3 patients had complicated AND, and 2 patients had TEF which were induced by Nickel-Titanium alloy mesh stent for treating benign esophageal stricture. All these patients were retrospectively studied in Tangdu Hospital. Treatment consisted of conservative therapy of TEF, staged surgical repair of TEF and laryngotracheal reconstruction according to the dimension (small or large) of TEF and complications.</p><p><b>RESULTS</b>Four patients with small TEF (2 - 3 mm length) complicated LTS underwent laryngotracheal reconstruction stented with silicone T tube and TEF was adopted conservative treatment. The TEF and LTS were healed. Six patients with larger TEF (10 - 25 mm length) were repaired by staged surgical repair of TEF and laryngotracheal reconstruction. Among them, 3 cases had complicated LTS and AND, 2 cases had recent LTS and 1 case had TEF without complication. Two patients had TEF and LTS, whose TEF healed before laryngotracheal reconstruction, the remnant LTS were reconstructed and healed. During the follow-up ranged from one to ten years, 12 patients were successfully treated without complications. One patient with TEF and LTS was treated only LTS because of a segment of esophagus was closed and treated with esophagogastrostomy in the department of thoracic surgery after LTS was successfully reconstructed and cured. One patient died of bleeding and asphyxia induced by the Nickel-Titanium alloy stent because of the stent had not been taken out.</p><p><b>CONCLUSION</b>The small cervical TEF complicated or remnant LTS can be treated by laryngotracheal reconstruction and conservative treatment of TEF at the same time. A larger TEF complicated LTS should be treated by staged repair of TEF and LTS.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Cutaneous Fistula , Diagnosis , General Surgery , Esophageal Stenosis , Diagnosis , General Surgery , Retrospective Studies , Tracheoesophageal Fistula , Diagnosis , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To prepare a decellularized whole laryngeal scaffold by utilizing a perfusion-decellularized technique, reseed cells on it, and construct decellularized laryngeal muscles.</p><p><b>METHODS</b>Perfusion decellularized larynxes were obtained by common carotid arterious perfusion with detergents. Then they were performed by macroscopic view, histological examination, scanning electron microscopy (SEM) and cartilage viability. Decellularized laryngeal scaffold were then reseeded with inducted mesenchymal stem cells (MSCs). Composites were transferred into greater omentums of rabbits after one day's adherence and harvested after eight weeks. Macroscopic view, histological examination and immunohistochemistry were performed.</p><p><b>RESULTS</b>Perfusion larynxes became transparent after two hours. Histology and SEM indicated that perfusion method showed better decullularized effect. More vintages and collagen fibers but no intact cell or nuclei were retained in the decellularized matrix. Porosity measured by Image pro plus 6.0 was 80.4% +/- 3.2% (x +/- s). Chondrocyte vitality assay indicated chondrocyte vitality rate in the perfusion group was 86.9% +/- 1.5%. After eight weeks, vascularization formed and integrated cartilage frameworks still remained. Histological examination could clearly show the presence of muscle bundles and vessels. Immunohistochemical examination indicated that sarcomeric-alpha actin expressed positively in corresponding areas.</p><p><b>CONCLUSIONS</b>It is feasible to reseed MSCs into the decellularized laryngeal muscle matrix for constructing tissue-engineered laryngeal muscles. This in vivo maturation into the omentum could be the first step before in situ implantation of the construct.</p>