Value of ultrasound in the diagnosis of intraneural perineurioma / 中华超声影像学杂志

Objective:To investigate the value of ultrasound in the diagnosis of intraneural perineurioma.Methods:From June 2015 to June 2022, 11 patients with intraneural perineurioma confirmed by surgery or biopsy in Provincial Hospital Affiliated to Shandong First Medical University were retrospectively collected, all of whom underwent high-frequency ultrasound examination. Clinical data and sonographic characteristics were collected. The maximum cross-sectional area of the affected nerve was recorded and compared with the corresponding site of the contralateral nerve.Results:All the 11 cases of intraneural perineurioma were single neuropathy. The sonogram showed that the affected nerve was spindle shaped and thickened. There was a statistical difference between the maximum cross-sectional area of the thickened intraneural perineurioma and the corresponding site of the contralateral nerve [(0.158±0.043)cm vs (0.044±0.012)cm, t=8.669, P<0.001]. The fascicles of the affected nerve were thickened with loss of normal fascicular definition, but there were still hyperechoic linear separation among the fascicles. Conclusions:High-frequency ultrasound may be a valuable technique for the diagnosis of intraneural perineurioma.

Research on medical radioisotope production technology by medium and high-energy cyclotron and solid target / 中华核医学与分子影像杂志

In this paper, the domestic and international demand and development trend of clinical diagnostic radionuclides are analyzed, and the medium and high-energy cyclotrons, adequate and systematic facilities, and preparation techniques required for the production of medical radionuclides based on solid targets are introduced. This paper focuses on the research and development carried out by some important medical institutions and scientific research institutes in China over the years in the aspects of medium and high-energy cyclotrons, beam transmission lines, high-power irradiation target stations and new medical isotope production processes etc. It also looks forward to some new directions for the development of medical radionuclides in China during the 14th Five-Year Plan period.

Preparation and use of the 225Ac- 213Bi generator / 中华核医学与分子影像杂志

Objective:To develop radiopharmaceuticals for targeted alpha therapy (TAT), a simple and useful 225Ac- 213Bi generator was developed to provide a short half-life α-emitter 213Bi. Methods:DIPEX resin was used as the stationary phase of the generator, a Sep-Pak Alumina N Plus Light Cartridge column was utilized as the column to construct the generator, and hydrochloric acid was used as the eluent. The γ spectrometer was used to determine the purity of the eluted 213Bi and verify the method to measure the radioactivity of 225Ac and 213Bi by using radioisotope calibrators. The elution curves of the generator at various settings were analyzed to find the best elute and storage conditions. Results:Using commercial 225Ac, 100 mg DIPEX resin and a Sep-Pak Alumina N Plus Light Cartridge column, a 225Ac- 213Bi generator with a column volume of 0.35 ml was constructed, which could be eluted 213Bi with a syringe drenched with hydrochloric acid. The produced 213Bi was pure, and the measured half-life was (45.75±0.12) min, which was consistent with the theoretical value (45.6 min). CRC ? calibrators with setting numbers of #086 and #018 could measure the activity of 225Ac and 213Bi with the average errors of -2.6% and + 0.2% respectively. The eluent for the 225Ac- 213Bi generator was 2 mol/L hydrochloric acid, of which 320 μl was required only to get 90% elution yield. The generator was recommended to be stored directly in the eluent to avoid drying. Conclusion:The 225Ac- 213Bi generator can be constructed to obtain 213Bi for TAT.

Clinical factors associated with composition of lung microbiota and important taxa predicting clinical prognosis in patients with severe community-acquired pneumonia / 医学前沿

Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R2 = 0.033; P = 0.018), followed by acute kidney injury (AKI; R2 = 0.032; P = 0.011) and plasma MIP-1β level (R2 = 0.027; P = 0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.

Relationship of Claudin-1 and VEGF-C protein with colorectal cancer / 重庆医学

Objective To investigate the expression of tight junction protein 1(Claudin‐1) and vascular endothelial growth factor C(VEGF‐C) in colorectal carcinoma tissues and the relationship between them .Methods Totally 50 cases of colorectal carci‐noma ,paracancerous tissues and 50 cases of normal colorectal tissues from Department of Pathology were detected by immunohisto‐chemistry SP method ,according to the patient′s age ,gender ,lymph node metastasis ,depth of invasion ,clinical stage for comprehen‐sive comparison ,and analyze the Claudin 1 and VEGF‐C protein expression in colorectal cancer tissues .Results The positive rates of Claudin‐1 ,VEGF‐C in colorectal cancer tissues was significantly higher than that in paracancerous tissue and normal colorectal tissues (χ2 =32 .270 ,P=0 .000;χ2 =41 .209 ,P=0 .000) ,the positive rate of Claudin‐1 ,VEGF‐C in paracancerous cancer tissues was significantly higher than that in normal colorectal tissues (χ2 =7 .294 ,P=0 .007 ;χ2 = 5 .741 ,P=0 .017) .The expression of colorectal carcinoma Claudin‐1 had close relationship with differentiation ,invasion degree ,TNM stage ,lymph node metastasis(P<0 .05) ,the expression of VEGF‐C had colse relatons with infiltration degress ,TNM stage ,lymph node metastasis ,tumor size(P<0 .05) .The expression of colorectal cancer Claudin‐1 ,VEGF‐C had significantly positive correlation (χ2 =10 .953 ,P= 0 .001 ,r=0 .468) .Conclusion The expression of colorectal cancer Claudin‐1 ,VEGF‐C was significantly higher than that in paracancerous tis‐sue and normal colorectal tissue ,the expression of Claudin‐1 ,VEGF‐C had a certain relationship with clinical staging .

Donor site repair of great toe-nail flap in finger reconstruction surgery / 中华显微外科杂志

ObjectiveTo explore methods of donor repair of the great toe-nail flap in finger reconstruction surgery.MethodsFrom December 1998 to December 2010, various kinds of flaps were used in 511 donor sites to repair the great toe-nail flaps,including:32 dorsal pedal artery flaps;twenty-four first dorsal metatarsal artery flaps;twenty-one second dorsal metatarsal artery flaps;forteen anterior malleolar flaps;seventeen medial tarsal artery flaps;seventy-nine lateral tarsal artery flaps;one hundred and six plantar metatarsal flaps,seventy-nine flaps from second toe;fifteen flaps from mid/lower leg and 124 freed flaps.ResultsAfter postoperative 6 months to 11 years of follow-up, repaired donor sites of great toe-flaps all survived successfully,with ideal outlook and function.ConclusionThere are many kinds of methods for donor site repair of the great toe-nail flap,and each kind of method has its own advantages and disadvantages. Among these flaps, plantar pedal artery flap and free groin flap are amony the best ones.

Full reconstruction of Ⅰ to Ⅲ-degree finger defect / 中华显微外科杂志

ObjectiveTo introduce the new method of full reconstruction for Ⅰ to Ⅲ-degree finger defect.MethodsFor reconstruction of Ⅰ to Ⅱ-degree finger defect, the surgery procedure was as follows:Harvest part of nail,skin and dorsal part of distal phalanx from hallux to form a composite flap,and then the flap was transplanted to the finger stump to reconstruct the defect part of the finger.The design of the composite flap was according to the recipient part. For reconstruction of Ⅲ-degree finger defect, the skin included in the flap could be designed according to the recipient part, but the bone can only be harvested from the fibulodoral part of the hallux and far from the insertion of the extensor hallucis longus tendon, which means the length was limited.If the bone length was not enough,one bone mass with appropriate size and shape was harvested from the iliac bone and connected with the bone of the composite flap. Some cases of Ⅲ-degree finger defect were reconstructed by harvesting interphalangeal joints from the second toes to reconstruct distal interphalangeal joints(DIP). The bone defect was reconstituted by bone mass from the iliac bone to conserve the contour of the second toe.The hallux wound was covered by a local flap or free flap transplantation.ResultsOne hundred and eighteen cases (126 fingers) of Ⅰ-degree defect, one hundred and eighty-seven cases (201 fingers) of Ⅱ-degree defect and 90 cases (111 fingers) of Ⅲ-degree finger defect were applied full reconstruction. All the reconstructed fingers survived completely and the configurations were similar to real fingers. Followed up our work on 150 fingers from a number of patients, between 1 and 11 years after the original surgery.Total ranges of motion of the reconstructed fingers got to over 180°.The reconstructed DIP joints had the range of motion of 15°-40°. The donor halluxes and toes were conserved with the normal length,relatively primary appearance and full function. ConclusionFull reconstruction for Ⅰ to Ⅲ-degree finger defect has great advantages in that the reconstructed finger has very realistic configuration as well as ideal function and the donor hallux is conserve well.

Value of magnetic resonance imaging on local-regional staging of endometrial carcinoma / 肿瘤研究与临床

Objective To assess the value of magnetic resonance (MR) imaging (MRI) in depicting the depth of myometrial infiltration, cervical invasion and lymph nodes metastasis in patients with endometrial carcinoma compared with surgicopathologic findings. Methods Thirty-eight patients with endometrial carcinoma diagnosed by pathology were inspected by MRI in this prospective study. MR images were analyzed by two radiologists to report the depth of myometrial infiltration, infiltration of the uterine cervix and lymph nodes metastasis. MRI and surgicopathologic staging of endometrial carcinoma were based on FICO classification. MRI findings were compared with surgicopathologic findings. Results The overall accuracy rate of MRI in staging endometrial carcinoma was 77.1 %. The results of Kappa statistics showed that there was strong consistency between MRI and surgicopathology for staging of endometrial carcinoma (k= 0.677). Respective diagnostic accuracy, sensitivity, specificity, negative and positive predictive values in assessing myometrial infiltration(>l/2 depth) were 91.4 %, 83.3 %, 95.6 %, 91.7 % and 90.9 %; those in cervical infiltration were 94.2 %, 80.0 %, 96.7 %, 96.7 %, and 80.0 %; and those in lymph node assessment were 96.2 %, 66.7 %, 100 %, 95.8 % and 100 %. Conclusion MRI is highly accurate in depicting the depth of myometrial infiltration, cervical invasion, lymph nodes metastasis and local-regional staging of endometrial carcinoma.

Repair of soft tissue defects on the foot and ankle with flaps of cutaneous branches of the low medial leg / 中国微创外科杂志

Objective To investigate clinical effects of cutaneous branch flaps of the low medial leg for the repair of soft tissue defects on the foot and ankle.Methods A flap with pedical of cutaneous branches of the low medial leg was used for the repair of 7 cases of skin and soft tissue defects on the feet and ankle from March 2003 to October 2005.The cutaneous branches of the posterior tibial artery were identified along the medial border of the tibia and between the soleus muscle and the flexor digitorum longus muscle.The flap was mobilized according to the site and length of the cutaneous branches,and was transferred to soft tissue defects for skin grafting. Results The operating time was 3~5 hours(mean,4.2 hours).The flaps survived completely in all the 7 cases.Follow-up checkups were carried out for 5~18 months(mean,10 months).The appearance and functions of the foot were satisfactory and met the requirements for daily activities.Conclusions The procedure can effectively repair soft tissue defects on the foot and ankle and does not sacrifice the major arteries.This flap is easy to be prepared.