ABSTRACT
Objective To explore the diagnosis and treatment process and experience of emergency interventional ultrasound in our hospital under the coronavirus disease 2019 (COVID-19) epidemic situation, so as to provide reference for the safe and effective implementation of interventional ultrasound during the epidemic. Methods This study summarized and reviewd the experience of interventional ultrasound for the diagnosis and treatment of three emergency patients in the department of ultrasound of our hospital during the COVID-19 epidemic, focusing on the screening of severe COVID-19 patients, the selection of indications for interventional puncture, the perioperative protection and postoperative management. Results According to epidemiological screening, patient 1 had close contact with the confirmed COVID-19 patient. Chest CT showed diffused interstitial exudation in the lower lobes of both lungs, and the patient was seen as a suspected case after consultation with the hospital expert group, who had retropharyngeal space infection on admission and needed to remove the infection focus quickly. COVID-19 was excluded in patient 2, who was diagnosed as acute episode of calculous incarcerated cholecystitis on admission, requiring rapid drainage of bile to relieve gallbladder obstruction. Patient 3 was excluded from COVID-19 and diagnosed as acute pericardial tamponade on admission, requiring rapid drainage of pericardial effusion. All 3 patients underwent strict COVID-19 screening procedures to identify the indications of interventional puncture. During the operation, tertiary protective measures were adopted for patient 1, and primary protective measures were adopted for the other two patients. Three severe patients were successfully treated by interventional ultrasound, with short average time, less bleeding and improved clinical symptoms. Conclusion Interventional ultrasound is minimally invasive, convenient and efficient, making it suitable for the emergency treatment during the COVID-19 epidemic. It can be used as an alternative to some emergency surgery, or provide a safe window period for confirmed or suspected severe COVID-19 patients. Our experience may provide a reference for the safe and effective practice of interventional ultrasound during the COVID-19 epidemic..
ABSTRACT
@#Objective To investigate the effects of a self-powered conduit in different patients’ models who underwent extracardiac Fontan procedure. Methods Four children who underwent extracardiac Fontan procedure in Shanghai Children's Medical Center from 2011 to 2017 year were selected. Venae cavae and pulmonary arteries were reconstructed using Mimics 19.0®. In silico, a venturi conduit was introduced to the anastomosis of venae cavae and pulmonary artery. Then computational fluid dynamics simulation was performed using patients’ clinical data. Results When inferior venae cavae were directly to or to the left of superior venae cavae, the venturi conduit could assist the return of venous blood and reduce the pressures of venae cavae about 0.5 mm Hg. And the pressure differences between venae cavae and pulmonary arteries were about –0.7 mm Hg, which suggested that the conduit could generate right ventricle-like effect. Conclusion The venturi conduit can reduce the pressure of venae cavae, increase pulmonary circulation flow and improve Fontan hemodynamics.
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To perform a systemic review and meta-analysis of the diagnostic accuracy of PET (CT) and metaiodobenzylguanidine (MIBG) for diagnosing neuroblastoma (NB),electronic databases were searched as well as relevant references and conference proceedings.The diagnostic accuracy of MIBG and PET (CT) was calculated for NB,primary NB,and relapse/metastasis of NB based on their sensitivity,specificity,and area under the summary receiver operating characteristic curve (AUSROC) in terms of per-lesion and per-patient data.A total of 40 eligible studies comprising 1134 patients with 939 NB lesions were considered for the meta-analysis.For the staging of NB,the per-lesion AUSROC value of MIBG was lower than that of PET (CT) [0.8064±0.0414 vs.0.9366±0.0166 (P＜0.05)].The per-patient AUSROC value of MIBG and PET (CT) for the diagnosis of NB was 0.8771±0.0230 and 0.6851±0.2111,respectively.The summary sensitivity for MIBG and PET (CT) was 0.79 and 0.89,respectively.The summary specificity for MIBG and PET (CT) was 0.84 and 0.71,respectively.PET (CT) showed higher per-lesion accuracy than MIBG and might be the preferred modality for the staging of NB.On the other hand,MIBG has a comparable diagnosing performance with PET (CT) in per-patient analysis but shows a better specificity.
ABSTRACT
A large pedigree of progressive symmetric erythrokeratoderma is reported. The proband was a 22-year-old male with generalized asymptomatic lesions characterized by symmetrical well-demarcated erythematous hyperkeratotic plaques mainly distributed on the extremities. The proband's parents were also affected, and they were first cousins. Thus, a case of familial progressive symmetric erythrokeratoderma is described.