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Objective@# Using computer-assisted navigation technology to guide the resection and reconstruction of mandibular ameloblastoma, evaluating its treatment effect.@*Methods @# Twelve patients were selected from the Affiliated Stomatological Hospital of Nanjing University from January 2017 to May 2022. All 12 patients accepted same surgery which included resection of mandibular ameloblastoma and reconstruction by fibula musculocutaneous flap. Among them, 6 cases were included in the navigation group; 6 cases were in the non-navigation group. Advantages and disadvantages of computer-assisted navigation technology in this operation were evaluated with these cases. @*Results@# The 12 operations were performed by the same operator. The average time for fixing the navigation bracket and performing navigation in the navigation group was about 15 minutes. Compared with the non-navigation group, the average operation time in the navigation group was shortened by about 10 minutes. In the navigation group, the mandible resection range matched the fibula musculocutaneous flap well, and the occlusal relationship recovered well. @*Conclusion @#Using the mandibular reference frame, under the guidance of computer-assisted navigation technology, the resection and reconstruction of mandibular ameloblastoma can be performed quickly and accurately.
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Objective:To compare the hemostatic effects and patient comfort of different compression methods for hemostasis after transradial coronary intervention.Methods:A total of 160 patients who received transradial coronary intervention in The Affiliated Hospital of Hangzhou Normal University from October 2018 to February 2020 were included in this study. In group A ( n = 80), patients underwent spiral compression at the puncture point (release for 1 turn at 2 hours after surgery, rotation for 1 circle after 1 hour, and full decompression). In group B ( n = 80), patients underwent spiral compression at the puncture point (release for 1 turn at 2 hours after surgery, rotation for 1 circle after 2 hours, and full decompression). Percutaneous arterial oxygen saturation value in the affected limb, heart rate, and Visual Analog Scale score at different times after surgery, pain and comfort score at 2 and 12 hours post-surgery were compared between the two groups. Results:Percutaneous arterial oxygen saturation value at 4 and 12 hours post-surgery in group A was (96.6 ± 0.7)% and (97.8 ± 0.5)%, respectively, which was significantly higher than that in group B [(96.2 ± 0.6)%, (97.6 ± 0.7)%, t = 3.88, 2.08, both P < 0.05]. There were no significant differences in total score and subscale score of the General Comfort Questionnaire at 2 hours post-surgery between groups A and B (both P < 0.05). At 12 hours post-surgery, scores of psychological and physical subscales and total score of the General Comfort Questionnaire in group A were (23.64 ± 3.02) points, (12.64 ± 2.05) points, (68.25 ± 6.04) points, which were significantly higher than those in group B [(22.20 ± 2.96) points, (11.38 ± 2.47) points, (64.42 ± 6.71) points, t = 3.05, 3.51, 3.79, all P < 0.05]. At 2 hours post-surgery, there was no significant difference in Numerical Rating Scale score between groups A and B ( P > 0.05). At 4 and 12 hours post-surgery, Numerical Rating Scale score in group A was (2.51 ± 0.58) points and (1.75 ± 0.76) points, respectively, which was significantly lower than that in group B [(2.95 ± 0.63) points, (2.31 ± 0.71) points, t = -4.59, -4.82, both P < 0.05). The incidence of complications was significantly lower in group A than in group B (8.75% vs. 20.00%, χ2 = 4.11, P < 0.05). Conclusion:Compression for hemostasis is highly effective by releasing for 1 turn at 2 hours after transradial coronary intervention, rotating for 1 circle after 1 hour, and full compression because it can greatly mitigate pain, ensure the oxygen supply to the affected limbs, and improve patient comfort.
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Coagulometer, known as blood coagulation analyzer, is a product that can provide accurate test results for medical diagnosis and treatment analysis by detecting a series of items closely related to thrombosis and hemostasis in coagulation reaction. On the basis of previous traditional methods, and with our deep understanding about the principles of hemagglutination detection, we propose a hemagglutination detection method by using the dual-magnetic circuit beads method. Then, the corresponding hemagglutination detection module is designed. The coagulation time of plasma can be measured by detecting the movement of the magnetic beads when the magnetic field intensity is appropriate. The activated partial thromboplastin time(APTT) of plasma is tested when the most suitable magnetic field intensity is found. The results preliminarily show that this blood coagulation test method is valid and the corresponding test module has a potential value in business.
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Blood Coagulation , Blood Coagulation Tests , Magnetic Phenomena , Magnetics , Partial Thromboplastin TimeABSTRACT
Objective We aimed to evaluate the efficacy and safety of fecal microbiota transplantation (FMT) for the treatment of ulcerative colitis (UC) in this Meta-analysis.Methods Literature related to FMT for the treatment of UC from PubMed,Embase,Cochrane databases,CNKI,VIP and Wanfang Data were searched and screened with update study in May 2018.Two independent investigators extracted information according to inclusion and exclusion criteria.The Meta-analysis was conducted by Stata 12.0 software.Results A total of 4 randomized controlled trials (RCTs) and 19 non-randomized controlled trials (non-RCTs) including 536 participants met the inclusion criteria.Meta-analysis of RCTs showed that FMT significantly increased the clinical remission rate (OR=2.47,95％CI 1.40-4.33,P=0.02) and clinical response rate (OR=1.86,95％CI 1.15-3.02,P=-0.01) in UC patients without increasing the incidence of severe adverse effects (OR=1.40,95％CI 0.51-3.79,P=-0.51).The results from 19 non-RCTs showed that clinical remission rate in UC patients with FMT treatment was 20％(95％CI 13％-28％) and the clinical response rate was 50％(95％CI 36％-65％).All adverse events were graded as mild and self-resolving.No FMT-related severe adverse effects were reported.Conclusions Our analysis suggests that FMT is a safe and effective method for the treatment of UC.Considering several limitations of this Meta-analysis and previous clinical trials,further large-scale multicenter RCTs are still required to further verify the conclusion.
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Objective@#To evaluate the feasibility and safety of transanal lateral lymph node dissection for mid-low rectal cancer.@*Methods@#A descriptive case series research method was used. Clinical and pathological data of 5 mid-low rectal cancer patients who underwent transanal lateral lymph node dissection at Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University from November 2018 to May 2019 were retrospectively collected and analyzed. Of 5 cases, 4 were male and 1 was female with mean age of (43.2±13.2) years and mean body mass index of (21.2±2.6) kg/m2; the mean diameter of tumor was (3.2±2.4) cm; the mean distance between tumor and anus was (6.3±2.5) cm; 3 received preoperative neoadjuvant chemotherapy. In preoperative TNM staging, 2 cases were T3N1M0, 1 was T3cN2aM0, 1 was T3cN2bM0, and 1 was T2N1M0. All the patients had no intestinal obstruction before operation. Surgical methods: (1) total mesorectal excision: using general transanal and transabdominal methods to mobilize and resect total mesorectum, and dissect No.252, No.253 lymph nodes; (2) transanal lateral lymph node dissection: dissect the adipose lymphoid tissue on the surface of the iliococcygeal muscle, the coccygeal muscle, and the obturator muscle (the No.283 lymph nodes) upward, and dissect No.263d and No.263p lymph nodes with fat tissue sequentially till the bifurcation of the internal and external iliac artery; (3) take out the specimen from anus, and make anastomosis between proximal colon and anal canal. Intraoperative and postoperative variables was observed.@*Results@#All the 5 patients completed surgery successfully, and no patient needed to convert to open approach. The mean operative time was (295.6±97.7) minutes, and the median intraoperative blood loss was 70 (50-500) ml. The mean length of specimen was (12.9±3.0) cm, and the mean number of harvested lymph node was 30.4±9.9. The positive lateral lymph nodes were founder in 4 patients. The median distance between tumor and distal resection margin was 1.5 (1.2-8.0) cm. The resection margin in all the patients was negative. The mean time to postoperative flatus was (4.2±1.6) days, the mean postoperative spontaneous urination was (3.0±1.9) days, time to drainage tube removal was (5.6±1.9) days, and the mean postoperative hospital stay was (9.4±2.1) days. The postoperative TNM staging by pathology was 1 case with T1N0M0, 1 with T2N1M0, 1 with T3N2bM0, and 2 with T3N2M0. Five patients were moderately differentiated adenocarcinoma. Only 1 patient developed postoperative abdominal bleeding, who was healed after conservative treatment. The other 4 patients did not develop any perioperative complications, such as incision infection, presacral abscess, pelvic abscess, anastomotic leakage, or anastomotic stricture. Four patients underwent postoperative chemotherapy. All the patients were followed up for 2 to 28 weeks after surgery and they all felt well. The patients with stoma had fluent bowel.@*Conclusions@#Transanal lateral lymph node dissection is feasible and safe in the treatment of mid-low rectal cancer, which can achieve the purpose of extended radical resection of mid-low movement rectal cancer. Moreover, this procedure is a new method to treat rectal cancer patients with lateral lymph node metastasis.
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Further healthcare system reform calls for desirable pathway design. This paper introduced the logical framework of the new healthcare system reform pathway design and typical practical experience in Hangzhou.Known for " Internet+Smart healthcare" forerunner, Hangzhou has pioneered the reform of public hospitals and the construction of smart handy service for the public.With the aim of fully protecting the health rights and interests of urban and rural residents, comprehensive policy has been taken to deepen the reform of public hospitals; with the comprehensive promotion of contracted services and the primary level sharing of resources as a carrier, we will build a hierarchical medical service system of vertical linkage.We will also innovate and practice the governing philosophy of " Medicine has its limitations but we have the courage to overcome, service is boundaryless and we must pursue excellence".Promotion of party building in the industry also ranks high.Deepening the reform of " one visit for all" in the field of medical and health services as a measure to enhance people′s sense of gain; The " public-private partnership" to encourage the development of the social governance system and legalization in healthcare proves successful at this stage. However, there are still many challenges in the information security maintenance of smart healthcare, the balance of stakeholder interests in public hospitals, the all-round advancement of hierarchical medical service, standardizing and streamlining the reform of " one visit for all".
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Objective To investigate the long-term efficacy of pure transanal total mesorectal excision (PtaTME) for middle-low rectal cancer.Methods The retrospective descriptive study was conducted.The clinicopathological data of 18 patients with middle-low rectal cancer who were admitted to the Sixth Affiliated Hospital of Sun Yat-sen University from July 2014 to August 2016 were collected.There were 7 males and 11 females,aged (58±13) years,with a range from 40 to 84 years.The body mass index was (22±3) kg/m2.All the 18 patients underwent PtaTME.Observation indicators:(1) surgical and postoperative conditions;(2) postoperative pathological examination;(3) follow-up and survival.Follow-up using inpatient reexamination,outpatient examination,and telephone interview were performed to detect anastomotic complications,anal function,urinary retention,sexual dysfunction,survival and tumor recurrence and metastasis once every 3 months within postoperative 6 months,once every 6 months from 6 months to 3 years,and once a year after 3 years up to June 2019.The measurement data with normal distribution were represented as Mean±SD,and the measurement data with skewed distribution were represented as M (range).Count data were expressed as percentages.Survival rates were calculated by the Kaplan-Meier method.Results (1) Surgical and postoperative conditions:18 patients successfully underwent PtaTME,without conversion to open surgery.The operation time,volume of intraoperative blood loss,distance between anastomosis and anal verge,time to first flatus,time to urinary catheter removal,and duration of postoperative hospital stay were (202±68) minutes,50 mL (range,20-400 mL),(4.5± 2.0)cm,2 days (range,2-7 days),3 days (range,2-5 days),and 7 days (range,5-10 days) in the 18 patients,respectively.There was no perioperative complication.Among 18 patients,4 underwent preventive ileostomy.(2) Postoperative pathological examinations:the length of surgical specimens,the number of lymph node dissection,distance from tumor to the distal margin were (11.0±3.0)cm,12±6,and 1.0 cm (range,0.8-3.7 cm),respectively.The 18 patients had complete mesorectal membrane excision,with negative proximal margin,distal margin,and circumferential margin.Tumor pathological staging:there were 2 cases in Tis stage,4 in T1 stage,7 in T2 stage,and 5 in T3 stage;16 in N0 stage,1 in N1 stage,and 1 in N2 stage.Tumor histological classification:2 patients had carcinoma in situ,9 had moderately differentiated adenocarcinoma,and 7 had high-differentiated adenocarcinoma.(3) Follow-up and survival:18 patients were followed up for 34.0-59.0 months,with a median follow-up time of 57.5 months.During the follow-up,4 patients developed grade B anastomotic leakage and were cured after conservative treatment.One patient developed anastomotic recurrence at 2 years after surgery,and no recurrence was found after surgical resection of the recurrent lesion.Four patients with prophylactic ileostomy had the stoma closured,and the anus function was satisfactory after surgery.There was no urinary retention or sexual dysfunction in the 18 patients.Of the 18 patients,17 had tumor free survival after surgery.The 3-year disease-free survival rate was 94.4％,and the 3-year overall survival rate was 100.0％ in 18 patients.Conclusion PtaTME can achieve high quality of specimen,which is safe and feasible for the treatment of rectal cancer.
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Objective To compare the clinical efficacies of transanal total mesorectal excision(TaTME) and laparoscopic total mesorectal excision (LapTME)for rectal cancer (RC).Methods The case-control matching method and retrospective cohort study were conducted.The clinicopathological data of 100 RC patients who were admitted to the Sixth Affiliated Hospital of Sun Yat-sen University between July 2014 and January 2016 were collected.Of 100 patients,50 undergoing TaTME and 50 undergoing LapTME were respectively allocated into the TaTME and LapTME groups by case-control matching method.Observation indicators:(1) operation situations:operation time,volume of intraoperative blood loss,cases with intraoperative complications and preventive stoma;(2) postoperative recovery:time for diet intake,time for out-of-bed activity,occurrence of complications within 30 days postoperatively and duration of hospital stay;(3) postoperative pathological examinations:postoperative pathological specimen length,number of lymph node harvest,distance from lower boundary of tumor to distant margin and cases with positive circumferential margin;(4) follow-up.Follow-up using outpatient examination and network tracing was performed to detect local tumor recurrence and distant metastasis up to December 2016.Measurement data with normal distribution were represented as x±s and comparison between groups was analyzed using the paired-samples t test.Measurement data with skewed distribution were represented as M (range).Comparisons of count data were analyzed using the chi-square test.Comparisons of measurement data with skewed distribution and ranked data were done by the nonparametric test.Results (1) Operation situations:operation time,volume of intraoperative blood loss,cases with intraoperative complications and preventive stoma were (259±111)minutes,100 mL (range,20-2 000 mL),2,28 in the TaTME group and (220± 80)minutes,50 mL (range,20-1 000 mL),1,33 in the LapTME group,respectively,with no statistically significant difference (t=1.90,Z=-0.30,x2 =0.34,0.01,P＞0.05).(2) Postoperative recovery:time for diet intake and time for out-of-bed activity were (1.6±0.5) days,(2.6±0.6) days in the TaTME group and (2.4±0.5)days,(3.5 ±0.6)days in the LapTME group,respectively,with statistically significant differences (t =8.90,11.30,P＜0.05).Cases with anastomotic fistula,bleeding and stenosis,intestinal obstruction,abdominal abscess and wound infection within 30 days postoperatively were 6,1,1,0,1,0 in the TaTME group and 5,1,2,2,1,2 in the LapTME group,respectively,with no statistically significant difference (x2=0.10,0.00,0.30,2.00,0.00,2.00,P＞0.05).Cases with urinary retention within 30 days postoperatively were 3 and 0 in the TaTME and LapTME groups,respectively,with a statistically significant difference (x2 =3.00,P＜0.05).Two and 2 patients with anastomic fistula underwent reoperation in the TaTME and LapTME groups respectively,and other patients were improved by symptomatic treatment.Duration of hospital stay was 7 days (range,5-36 days)and 8 days (range,6-29 days) in the TaTME and LapTME groups,respectively,with no statistically significant difference (Z =-0.90,P ＞ 0.05).(3) Postoperative pathological examinations:postoperative pathological specimen length,number of lymph node harvest,distance from lower boundary of tumor to distant margin and cases with positive circumferential margin were (11±3)cm,13±5,(1.3±0.7)cm,0 in the TaTME group and (12±3) cm,13±5,(1.3±0.7)cm,1 in the LapTME group,respectively,with no statistically significant difference (t=0.50,0.20,0.10,x2=1.00,P＞0.05).(4) Follow-up:100 patients were followed up for 9-27 months,with an average time of 18 months.During the follow-up,distant metastasis and local tumor recurrence were detected in 2,3 patients of TaTME group and in 2,2 patients of LapTME group,respectively,with no statistically significant difference (x2 =0.00,0.20,P＞0.05).Conclusions TaTME for RC is safe and feasible.Compared with LapTME,TaTME not only achieves identical pathological quality without increasing intra-and postoperative complications,but also benefits postoperative recovery of patients.
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Objective To evaluate the effect of hyperlipidemia on pulmonary uptake in the patients inhaling sevoflurane for anesthesia.Methods A total of 103 patients of both sexes,aged 20-50 yr,with body mass index of 18-25 kg/m2,of American.Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective operation under general anesthesia,were enrolled in the study.Anesthesia was induced with iv midazolam 0.1 mg/kg,vecuronium 0.1 mg/kg,fentanyl 0.l mg/kg and etomidate 0.3 mg/kg.Patients were mechanically ventilated after endotracheal intubation.Patients inhaled 2％ sevoflurane for 30 min at an oxygen flow rate of 2 L/min.The inspired concentrations (Fi) and expired concentrations (Fe,Fe≈alveolar concentration [Fa]) of sevoflurane were recorded at 1,3,5,7,10,15,20 and 30 min of inhalation (T0-7).Patients were divided into either control group group C) or hyperlipidemia group (group H) according to the results of blood lipid levels after the end of observation.The ratio of Fa/Fi and time spent in reaching the titration value (Fa/Fi =0.8) were calculated in each group.Results There were 67 cases in group C and 36 cases in group H.Compared with group C,the Fa/Fi ratio was significantly decreased at 5,7 and 10 min of inhalation,and the time spent in reaching the titration value was prolonged in group H (P ＜ 0.05).Conclusion The pulmonary uptake of sevoflurane is increased,which may be associated with increased blood/gas partition coefficient.
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Objective To investigate the clinical efficacy of unidirectional-loop caudal-medial approach for laparoscopic-assisted radical resection of right colon cancer.Methods The retrospective and descriptive study was performed.The clinical data of 37 patients who underwent laparoscopic-assisted radical resection of right colon cancer through unidirectional-loop caudal-medial approach at the Sixth Mfiliated Hospital of Sun Yat-sen University from January 2015 to March 2016 were collected.Tumor-free principle was followed and unidirectional-loop caudal-medial approach was conducted.Observation indicators included:(1) surgical situations:operation time,volume of intraoperative blood loss,(2) postoperative recovery:time to initial anal exsufflation,time of draining tube removal,postoperative complications,duration of postoperative hospital stay,(3) postoperative pathological examination:number of lymph node dissection,number of positive lymph node,length of specimen,incision margin,tumor pathological staging and type,(4) follow-up.All the patients were followed up using outpatient examination and telephone interview up to June 2016.Measurement data with normal distribution were presented as x ± s and measurement data with skewed distribution were presented as average (range).Results (1) Surgical situations:37 patients received successful operation,without conversion to open surgery and perioperative death.Operation time and volume of intraoperative blood loss in 37 patients were (170 ± 50)minutes and 50 mL (range,20-300 mL).(2) Postoperative recovery:time to initial anal exsufflation,time of draining tube removal and average duration of postoperative hospital stay were (3.5 ± 1.0) days,(4.3 ± 1.1) days and 10 days (range,6-21 days),respectively.Two patients with postoperative wound liquefaction were improved by symptomatic treatment,and the other patients had no complication.(3) Postoperative pathological examination:number of lymph node dissection,number of positive lymph node,number of central lymph node dissection and length of specimen in 37 patients were 22 ±8,0 (range,0-6),6 ±5 and (32 ±9)cm,respectively,with negative incision margins.Postoperative tumor pathological staging showed that stage pT1,pT2,pT3 and pT4a were detected in 0,1,33 and 3 patients,and stage pN0,pN1 and pN2 in 23,12 and 2 patients,respectively.Postoperative tumor pathological type showed that 3,7,23 and 4 patients were respectively diagnosed with mucinous adenocarcinoma,high-differentiated adenocarcinoma,moderate-differentiated adeno-carcinoma and low-differentiated adenocarcinoma.(4) Follow-up:37 patients were followed up for 3-17 months with a median time of 11 months.During the follow-up,1 patient was complicated with anastomotic recurrence and 4 with distant metastases,the other 32 patients had tumor-free survival.Conclusion Unidirectional-loop caudal-medial approach for laparoscopicassisted radical resection of right colon cancer is safe and feasible,with a good short-term outcome,and it should be widely spread.
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<p><b>OBJECTIVE</b>To compare two different routes of totally implantable venous access ports (TIVPs) from the upper arm vein and the subclavian vein in terms of complications for patients with gastrointestinal malignancy.</p><p><b>METHODS</b>Patients who underwent implantations of TIVPs from September 2013 to January 2015 were retrospectively evaluated. The outcome measurements were rates and types of postprocedural early-stage and long-term complications.</p><p><b>RESULTS</b>A total of 208 patients(upper arm vein group, 86; subclavian vein group, 122) were included in this study. All TIVPs were implanted successfully. The rate of catheter displacement was higher in upper arm vein group(14.0% vs 5.7%, P=0.04), while other postprocedural early-stage complications had no significant difference between the two groups. The occurrence of transfusion obstacle and rates of overall postprocedural long-term complications were significantly lower in upper arm vein group than that in subclavian vein group(1.2% vs. 9.8%, P=0.02; 7.0% vs. 27.0%, P=0.01, respectively).</p><p><b>CONCLUSION</b>Compared with subclavian vein group, upper arm vein group has lower postprocedural long-term complication rates and is recommended as a safe and comfortable choice for port implantation.</p>
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<p><b>OBJECTIVE</b>The three-dimensional (3D) structure of left atrial appendage (LAA) in atrial fibrillation patients were reconstructed by Mimics 3D imaging system, aiming at guiding for selection of both the size and location of the closure devices and making preliminary risk assessment of LAA closure with Watchman system.</p><p><b>METHODS</b>Inclusion criteria were: ten voluntary patients with both atrial fibrillation and indication for LAA closure aging from 40 to 85 years old with contraindication for oral anticoagulants or unwillingness to take long-term oral anticoagulation therapy from May to December 2014. 3D reconstruction of LAA was preoperatively made by Mimics 3D imaging system. With the Mimics 3D reconstruction model and the results of both transesophageal echocardiography (TEE) and LAA radiography, the size and location for the closure device were chosen. The devices were planted at the ostium of the LAA.</p><p><b>RESULTS</b>Ten atrial fibrillation patients were enrolled (average age: (66.3±11.9) years old) and all successfully implanted with the Watchman LAA closure devices. Nine of them were with non-valvular atrial fibrillation with average CHADS2-VAS score (3.2±1.7) and HAS-BLED score (2.7±1.6). The rest one was a valvular atrial fibrillation patient with the history of the percutaneous balloon mitral valvuloplasty (PBMV) without surgical indications of mitral valve replacement (MVR). There was no blood leakage around the device by regular postoperative TEE and LAA radiography examinations. There were no complications of bleeding, embolism, or stroke through both at peri-operative period and at 1 month follow-up post procedure.</p><p><b>CONCLUSION</b>Preoperative Mimics 3D reconstruction of LAA by Mimics 3D imaging system among atrial fibrillation patients provides essential information guiding the successful LAA closures.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Humans , Middle Aged , Anticoagulants , Atrial Appendage , General Surgery , Atrial Fibrillation , General Surgery , Cardiac Surgical Procedures , Contraindications , Echocardiography, Transesophageal , Embolism , Imaging, Three-Dimensional , Prostheses and Implants , Prosthesis Implantation , Stroke , Treatment OutcomeABSTRACT
Objective To investigate the clinical value of 64-slice computed tomography with MinIP and MPR for imaging the bronchus related to a solitary pulmonary lesion (SPL). Methods Seventy-five subjects with solitary pulmonary lesions underwent chest 64-slice CT and their bronchi were analyzed retrospectively. All images of thin-section (0.625 mm) were reconstructed with MPR and MinIP into images of 1, 2, 3, and 5 mm thickness and 1 mm gap in two orthogonal planes along the long axis of bronchus related to the SPL. The image quality of four series of MinIP and MPR images was evaluated in the aspect of bronchus visibility and pulmonary vascular masking. One-way ANOVA with Bonferroni correction and interclass correlation coefficient were used in the statistical analysis. Results (1) The mean scores of display of the bronchi on MinIP images of four series (4.85, 4.77 and 4.84, 4.63 and 4.67, 4.25 and 4.28, in 1, 2, 3, and 5 mm thickness, respectively) and on MPR images of 1 or 2 mm thickness (4.77 and 4.76, 4.04 and 4.27, in 1 and 2 mm thickness, respectively) were good or excellent. MPR images of 1 mm thickness and MinIP images of 1-3 mm thickness showed no significant differences (t=0.318, P> 0.05 for all), but they were superior to MinIP images of 5 mm thickness (t=6.318 and 6.610, P＜0.01). MPR images of 2 mm thickness were inferior to MinIP images of 1-3 mm thickness (t=5.003-8.958, P＜0.01), but there was no significant difference between MPR images of 2 mm thickness and MinIP images of 5 mm thickness (t=1.794 and 0.3181, all P> 0.05). (2) The effect of suppression of pulmonary vascular markings on MinIP images was better with the increase of slice thickness (F=45.312 and 40.415, P＜0.01). The mean scores of MinIP images of 3 mm and 5 mm thickness (4.67 and 4.64, 5.00 and 4.97, for 3 and 5 mm thickness, respectively) were good or excellent, but MinIP images of 2 mm thickness were just acceptable. Conclusion MinIP images of 3 mm thickness may display the bronchus related to SPL more clearly.
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Objective To assess the changes in normal-appearing white matter fiber tracts of the brainstem in patients with relapsing-remitting multiple sclerosis (RRMS) quantitatively with diffusion tensor imaging (DTI). Methods Fifty patients with RRMS were recruited, and twenty five healthy volunteers with the same gender and age were selected as controls. Conventional magnetic resonance imaging and DTI was performed. Quantitative indexes as fractional anisotropy (FA) and mean diffusivity (MD) values in the brainstem fiber tracts, including corticopontine tract/corticospinal tract (cpt/cst), superior cerebellar peduncle (scp), middle cerebellar peduncle (mcp), inferior cerebellar peduncle (icp), and medial lemniscus (ml) were measured and analyzed. Results In comparison with controls, decreasing FA values in cpt/cst (L:P=0.030; R:P=0.020), icp (L:P=0.030; R:P=0.037), scp (L:P=0.036; R:P=0.041) and ml (L:P=0.014; R:P=0.035), as well as increasing MD values in cpt/cst (L:P=0.004; R:P=0.046), icp (L:P=0.047; R:P=0.011), scp (L:P=0.021; R:P=0.011) and ml (L:P=0.002; R:P=0.044) were found in patients with RRMS. No significant difference of FA and MD values was found in mcp between patients with RRMS and controls (P＞0.05). None of the MD or FA values in fiber tracts of the brainstem in patients with RRMS was correlated with brain parenchymal fraction (BPF) or T2 lesion volume. Conclusion The relevant abnormalities which were found in normal-appearing white matter fiber tracts of the brainstem in RRMS patients by DTI scanning suggested pathological changes. It is presumed that the changes may be due to demyelination caused by hiding lesions.
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Objective Atherosclerosis is widely accepted as a chronic inflammatory disease. Serum biomarkers for vulnerable plaques not only serve as diagnostic tools for the identification of patients with acute coro-nary syndrome, but also assist the identification of high-risk patients. However, the existing data are limited and conflicting. In the present study, we determined whether the plasma levels of interleukin-1β (IL-1β) are correlated with adverse cardiac outcomes in patients with ST-evaluate acute myocardial infarction (STEAMI) undergoing pri-mary percutaneous coronary intervention (PCI). Effect of the plasma intedeukin-1β level on prognosis of patients with ST-segment elevation acute myocardial infarction. Method This prospective single-center study included 96 patients with SIEAMI with onset < 12 h who underwent primary PCI, 271 patients with stable angina pectoris (SAP) and 148 control subjects without coronary artery disease who were consecutively admitted to hospital be-tween Mar, 2006 and Mar, 2008. Plasma IL-1β levels were measured by enzyme-linked immunosorbent assay in all subjects. The patients with STEAMI were then followed prospectively for the occurrence of major adverse car-diac events (MACE) (including cardiovascular death, non-fatal myocardial infarction, heart failure, and cardio-genie shock) during hospitalization. We determined the association between IL-1β levels with the risk of MACE using multivariate logistic regression. Results Compared with the SAP patients and control subjects, patients with STEAMI had higher levels of IL-1β (P < 0.05). During hospitalization, 32 patients (33.3%) experienced MACE [23 males, 9 females; age: (75.44±13.45) years]. In the STEAMI patients, IL-1β was elevated in patients with MACE compared with patients without MACE (median [range]: 26.52 [12.010 to 155.244] pg/mL vs 2.157 [0.433 to 83.021] pg/mL; P < 0.01) by non-parameter analysis. Significant and positive correlations be-tween IL-1β and cardiac troponin-I (cTnI) (r = 0.353, P =0.004) were observed by Spearman's correlations analysis. Multivariate logistic regression analysis revealed that IL-1β levels ≥20 pg/mL were significantly and in-dependently associated with MACE during hospitalization (odds ratio: 32.05; 95% confidence interval: 4.28 to 240.151; P =0.001). Conclusions The present study revealed that patients with STEAMI had elevated IL-1β levels on admission. The plasma IL- 1β level is an independent inflammatory predictor for in-hospital MACE in pa-tients with STEAMI undergoing percutaneous coronary intervention.
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50 as group B.All patients were examined by CAG.Plaque morphology was assessed by IVUS in 14 of group A and 38 of group B before intervention.Plaque external elastic membrane,minimal lumen area,plaque area,plaque burden,lipid pool area,thickness of fibrous cap and rupture were measured by IVUS.Results Heavy smoking,excess drinking and positive family history were more frequent in group A than those in group B,while hypertension and diabetes mellitus were more common in group B.The percentage multi-vessel lesions and collateral circulation were higher in group B.IVUS results showed that vulnerable and ruptured lesions were found in most of two groups.The severity of plaque burden is milder in group A.However,they had a bigger lipid core and a thinner fibrous cap.Group B showed a more severe stenosis and bigger plaque area.Conclusion Plaque vulnerability and rupture are the most common cause substrate of AMI.There are different risk factors and different coronary artery characteristics in AMI with different ages,which suggests that different emphases should be taken in preventing AMI in patients with different ages.
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Objective To investigate the imaging features of aggressive angiomyxoma.Methods CT findings in 3 patients and MRI finding among one of them with pathologically proved aggressive angiomyxoma were retrospectively analyzed and the relevant literature were reviewed.Results In all the 3 cases,CT and MR imaging demonstrated a well defined mass arising from the pelvis,perineum or vulva.The tumours displaced but did not invade adjacent structures of the pelvic.In 2 cases,there was marked enhancement following injecting contrast materials or T_2WI with internal swirling pattern.Recurrent tumour in one case was of similar imaging features to the primary lesion.The small cystiform area could be seen inside the lesion in one case.Conclusion Aggressive angiomyxoma carries certain characteristics in CT and MRI manifestations.MRI is more excellent than CT in delineating the site,shape and the extent of these lesions.
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Objective To evaluate the value of endorectal coil(E-coil) in the diagnosis of prostate diseases.Methods The comparative study was done with E-coil and body coil in 15 patients including 9 cases of prostate carcinoma,4 cases of benign prostatic hyperplasia and 2 normal individuals.The conventional spin-echo sequence(SE T 1WI,FSE T 2WI)were done in all cases.The axial images obtained with two types were compared according to the subjective viewing and scoring.Results Overall imaging quality on E-coil was significantly superior to that on body coil.The average scores were 2.97?0.61 points with body coil vs 3.4?0.60 points with E-coil on T 2WI (?
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70%(59 male and 22 female,mean age 61?11 years)were enrolled in the study,IVUS was done in 55 cases before and after percutaneous coronary intervention(PCI)with 24 patients from the SFCT group and 31 patients from the conventional percutaneous coronary angioplasty(POBA).Quantitative coronary angiography(QCA)measurements included minimal lumen diameter(MLD),reference lumen diameter(RLD)and diameter stenosis(DS);IVUS measurements include external elastic membrane area(EEMA),minimal lumen area(MLA),and area stenosis(AS),style of endomembrane tear and dissection.Results All the target lesions were successfully dilated in both groups without serious complications.Mean dilated pressure was lower in the SFCT group than that in the POBA group(871.4 kPa vs 1 013.2 kPa P
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Objective To investigate the effect of unfractioned heparin and low molecular weight heparin on expression of plasma hepatocyte growth factor(HGF)during percutaneous coronary intervention(PCI).Methods Seventy four patients with unstable angina pectoris were classfied into unfractioned heparin(UFH)group(n=49)and low molecular weight heparin(LMWH)group(n=25)according to the type of heparin used during PCI.The plasma levels of HGF were measured before,during,and after PCI in the patients.Results The plasma levels of HGF before procedure were of no statistical difference between the two groups.The levels of HGF were significantly increased during and after PCI in the unfractioned heparin and the LMWH group.Comparing with the pre-procedure level,the post-procedure level of HGF in the UFH group was 13 565.60?3 768.99 ng/L(vs 1 736.09?603.95 ng/L,P