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1.
Organ Transplantation ; (6): 115-2021.
Article in Chinese | WPRIM | ID: wpr-862785

ABSTRACT

Massive blood loss and blood transfusion constantly occur in liver transplantation. Over the past two decades, the amount of blood transfusion during the perioperative period has been decreased dramatically along with the continual maturity of liver transplantation techniques. The goal of liver transplantation without blood transfusion has been achieved. Since bleeding and blood transfusion are correlated with poor prognosis after liver transplantation, reducing bleeding and unnecessary blood transfusion has become the key objective during perioperative period of liver transplantation. In this article, adverse effects of allogeneic blood transfusion during perioperative period of liver transplantation, coagulation function monitoring of patients with end-stage liver disease, blood transfusion management of liver transplant recipients and the strategies of reducing perioperative blood transfusion in liver transplantation were summarized, aiming to provide reference for reducing the requirement of blood transfusion during perioperative period of liver transplantation.

2.
China Pharmacy ; (12): 195-200, 2021.
Article in Chinese | WPRIM | ID: wpr-862643

ABSTRACT

OBJECTIVE:To study the inhibitor y effects of cajanonic acid A on 5 kinds of cytochrome P 450(CYP)enzyme,in human liver microsomes in vitro . METHODS :By Cocktail probe substrate method ,50.0,15.0,5.0,1.5,0.5,0.15,0.05 μmol/L cajanonic acid A were added into liver microsomes , and incubated with mixed probe substrates [including phenacetin , dextromethorphan,omeprazole,testosterone and toluenesulfonbutylurea (probe substrates of CYP 1A2,CYP2D6,CYP2C19, CYP3A4,CYP2C9,respectively)]. On the basis of setting up blank group and positive control group [ α-naphthalene brass , quinidine,(+)-N-3-benzyl vanillin ,ketoconazole and sulfabendazole (specific inhibitors of CYP 1A2,CYP2D6,CYP2C19, CYP3A4,CYP2C9,respectively)],using puerarin as internal standard ,UPLC-MS/MS method was adopted to determine the contents of corresponding metabolites (acetaminophen, dextrophane, 5-hydroxy omeprazole , 6 β-hydroxytestosterone, hydroxytolbutamide). The determination was performed on ACQUITY UPLC ® BEH C 18 column,with mobile phase consisted of 0.01% formic acid aqueous solution- 0.01% acetonitrile formic acid (gradient elution )at the flow rate of 0.4 mL/min. The column temperature was 40 ℃,and the sample size was 2 μL. An electrospray ionization source was used to conduct positive and negative ion scanning in the multiple reaction monitoring mode. The data acquisition range was m/z 100-1 200,the collision gas was argon , the atomized gas was nitrogen ,the gas flow rate of the cone hole was 50 L/h,the desorption gas flow rate was 800 L/h,the capillary voltage under positive and negative mode was 2.0, 1.5 kV,and the ion source temperature was 120 ℃,110 ℃, respectively. The desolvent temperature were 400 ℃ and 450 ℃ , respectively. Non linear regression analysis was performed by using Graphpad Prism 5.0 software and IC 50 wascalculated. RESULTS :The linear ranges of above metabolifes were 0.26-8.35,0.36-34.56,0.10-3.09, 3.67-117.37,0.15-4.88 μmol/L(R2>0.99). The limits of quantitation were 0.26,0.36, 0.10,3.67,0.15 μmol/L,respectively. The IC 50 values of specific inhibitors in positive control group to CYP 1A2,CYP2D6, CYP2C19,CYP3A4 and CYP 2C9 in human liver microsomes were all within the acceptable range reported in the literature. The IC50 values of cajanonic acid A to CYP 1A2,CYP2D6 and CYP 3A4 in human liver microsomes were all more than 50 μmol/L,and the IC 50 values of CYP 2C9 and CYP 2C19 were 4.94 and 18.00 μmol/L,respectively. CONCLUSIONS :Cajanonic acid A has no inhibitory effect on CYP 1A2,CYP2D6 and CYP 3A4,but has a certain inhibitory effect on CYP 2C9 and CYP 2C19.

3.
Article in Chinese | WPRIM | ID: wpr-885817

ABSTRACT

Objective:To investigate the safety and early and mid-term efficacy of upper sternal mini-incision with debranching technique in B aortic dissection involving the arch.Methods:18 patients with B aortic dissection involving the arch who were admitted into our center from November 2017 to January 2019 were enrolled, to evaluate the intraoperative and postoperative conditions, including special intraoperative treatment, time of operation、poseoperative drainage、time of use ventilators, time of staying in ICU, complications etc, 12-24 months follow-up were performed after operation.Results:No death occurred, 1 case with acute renal failure, 1 case with type I endoleak, 1 case with paraplegia occurred during hospitalization, 1 patient with sudden vomiting of blood 30 days after discharge from hospital who was found aortoesophageal fistula, underwent emergency surgery to replace thoracic aortic and repair esophageal fistula, all of them were cured and discharged, the rate of complication was 22.2%(4/18). none of the other patients had any phenomena such as agnail、distal rupture、twisted or displaced of the stents、ischemic of coronary artery、cerebrovascular accident, etc.Conclusion:The result of upper sternal mini-incision with debranching technique in B aortic dissection involving the arch is satisfied, the early and mid-term survival rate is significantly improved, the patient's prognosis are improved.

4.
Chinese Journal of Digestion ; (12): 330-335, 2021.
Article in Chinese | WPRIM | ID: wpr-885753

ABSTRACT

Objective:Summarize and analyze the clinical features of immune checkpoint inhibitor (ICI)-related colitis.Methods:From January 2019 to September 2020, the clinical data of 8 patients with ICI-related colitis from Peking Union Medical College Hospital were retrospectively collected and including the onset of ICI-related colitis, clinical symptoms, endoscopic and pathological findings, treatment, comorbidities and resuming of ICI. Independent sample t test was used for statistical analysis. Results:Eight patients were all male, and the median age (range) was 66 years old (55 to 74 years old), 7 cases were diagnosed with stage Ⅳ lung cancer and 1 case was diagnosed with stage Ⅲc pyelo-carcinoma. Among 8 patients, 4 cases of ICI-related colitis occurred during combination of anti-programmed death-1 (PD-1) treatment and chemotherapy, 2 cases occurred during anti-PD-1 monotherapy after combination of anti-PD-1 treatment and chemotherapy, and 2 cases occurred after anti-PD-1 monotherapy. The median time (range) was 44 d (27 to 128 d) from initial anti-PD-1 treatment to the onset of ICI-related colitis and the median time (range) was 8 d (6 to 35 d) from last anti-PD-1 treatment to onset of ICI-related colitis. The ICI efficacy of 4 patients had partial response, 2 patients had stable disease, 1 patient had disease progression, and 1 patient′s condition was not assessed. All 8 patients had moderate to severe extensive colitis. The main clinical manifestation was diarrhea (5/8), 3 patients accompanied by abdominal pain. The endoscopic findings were diffuse mucosal erosion, accompanied by ulcer in 2 patients. The main pathologic findings were cryptitis or crypt abscess, accompanied by apoptosis in 2 patients. Eight patients were all treated with glucocorticoids, among them 2 patients were further treated with biologics, due to the insufficient efficacy of glucocorticoid treatment, 4 patients had opportunistic infections. The initial prednisone dose for patients with opportunistic infections and patients without opportunistic infections was (85.00±52.60) and (60.00±23.09) mg, respectively. The prednisone treatment course was (8.75±4.03) and (7.50±3.11) weeks, respectively, and the differences were not statistically significant (both P>0.05). The colitis relapsed in all 3 patients after resuming of ICI. Conclusions:ICI-related colitis had corresponding ICI treatment history and clinical, endoscopic, and histopathological features. Glucocorticoid is the main treatment, and it is prone to relapse after resuming of ICI.

5.
Article in Chinese | WPRIM | ID: wpr-885723

ABSTRACT

Objective:To investigate the clinical, endoscopic and pathological characteristics of synchronous multiple early gastric cancer (SMEGC), and to reduce the rate of missed diagnosis.Methods:Clinical data of 227 early gastric cancer patients treated by endoscopic submucosal dissection (ESD) and/or surgery in Songjiang Hospital, Shanghai Jiaotong University School of Medicine from January 2017 to December 2019 were retrospectively analyzed. The differences of clinical, endoscopic and pathological characteristics between solitary early gastric cancer (SEGC) group (200 cases) and SMEGC group (27 cases) were compared. The relevance of endoscopic and pathological features of major and minor lesions of SMEGC was also analyzed.Results:Among the 227 early gastric cancer patients, 27 (11.9%) were SMEGC (58 lesions), of which 25 cases were detected preoperatively, and 2 cases were reexamined within 6 months after surgery with another lesion found at a different site from the previous lesion. In the SMEGC group, the percentages of male and atrophy and intestinal metaplasia in surrounding mucosa were significantly higher than those of the SEGC group [85.2% (23/27) VS 61.5% (123/200), χ2=5.815, P=0.016; 96.3% (26/27) VS 81.0% (162/200), χ2=3.912, P=0.048]. The mean age of the SMEGC group was significantly higher than that of the SEGC group (68.7±6.7 years VS 63.8±9.8 years, t=-2.561, P=0.011). The correlation analysis showed a significant correlation between the major and minor lesions of SMEGC in the size of lesion ( r=0.640, P<0.001), vertical location ( r=0.518, P=0.006), macroscopic type ( r=0.904, P<0.001) and depth of invasion ( r=0.470, P=0.013). Conclusion:SMEGC is prevalent in elderly males with atrophic gastritis and intestinal metaplasia. It is necessary to be alert to the possibility of multiple cancer lesions, if an early cancer lesion is found under endoscopy, especially those that may have the same or similar shape and invasion depth in the same vertical distribution range.

6.
Article in Chinese | WPRIM | ID: wpr-885712

ABSTRACT

Objective:To investigate the features of common bile duct adenoma under endoscopic ultrasonography (EUS).Methods:Clinical data of 15 patients with common bile duct adenomas confirmed by pathology from January 2015 to January 2020 in Tianjin Nankai Hospital were analyzed retrospectively. The patients′ EUS features were summarized.Results:The common bile duct adenoma was characterized by homogeneous soft tissue mass with medium or low echo and clear boundary, floating in the bile duct with no movement under EUS. EUS diagnosis of 14 out of 15 patients was consitent with the pathology, and the diagnostic consistency was 93.3%. One patient with a movable lesion was misdiagnosed as cholestasis by EUS. One patient had two solitary adenomas, located in the middle and lower part of the common bile duct, and 14 others had single adenoma. There were 9 adenomas in the lower part, 4 in the ampulla, 2 in the upper part, and 1 in the middle of the common bile duct. The pathological findings were 7 cases of villous adenoma with high-grade intraepithelial neoplasia, 4 cases of local malignant changes; 6 villous tubular adenoma with high-grade intraepithelial neoplasia, 3 local malignant changes; 2 villous tubular adenoma with low-grade intraepithelial neoplasia; and 1 papillary adenoma.Conclusion:EUS, helpful for the qualitative diagnosis, can be used as an important technique to improve the diagnosis of common bile duct adenoma.

7.
Article in Chinese | WPRIM | ID: wpr-885565

ABSTRACT

Objective:To explore the association of the total gestational weight gain (GWG) and GWG in different trimesters with adverse pregnancy outcomes during the second pregnancy in women with history of gestational diabetes mellitus (GDM).Methods:This retrospective cohort study recruited 441 singleton pregnant women with a history of GDM who gave birth at Beijing Obstetrics and Gynecology Hospital of Capital Medical University from January 2017 to December 2018 as the GDM history group. Another 1 637 singleton pregnant women without a history of GDM who gave birth at the same period were selected through the mechanical sampling method as the control group. Independent sample t-test and Chi-square test were used to compare the differences in general conditions, GWG and perinatal outcomes between the two groups. Based on the Institute of Medicine guidelines for GWG, the subjects were further divided into three subgroups: inadequate GWG, adequate GWG and excessive GWG groups. Multivariate logistic regression analysis was used to compare the pregnancy outcome in women with the same GWG in different periods of pregnancy between the two groups. Results:(1) Women with GDM history had lower GWG before and after oral glucose tolerance test (OGTT) and the whole pregnancy than those without [(6.3±3.3) vs (7.9±3.7) kg, (4.8±2.6) vs (5.6± 2.6) kg, (11.8±4.6) vs (14.4± 4.6) kg; t=8.074, 5.183, 10.277; all P<0.001]. The incidence of GDM, gestational hypertension, and large for gestational age (LGA) in the GDM history group were higher than those in the control group [46.5% (205/441) vs 18.1% (296/1 637), 8.4% (37/441) vs 5.4% (88/1 637), 12.9% (57/441) vs 9.7% (158/1 637); χ2=153.181, 5.583, 4.013; all P<0.05]. (2) Before OGTT: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI for inadequate, adequate and excessive GWG were 4.02 (2.35-6.88), 3.92 (2.65-5.79) and 3.33 (2.11-5.25), respectively, all P<0.001]. Except for women with inadequate GWG, pregnancy with a history of GDM also had a higher risk of preeclampsia [ OR and 95% CI were 3.62 (1.47-9.23) and 2.22 (1.07-5.57) for adequate and excessive GWG, respectively, both P<0.05]. After OGTT: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI for inadequate, adequate and excessive GWG were 2.48 (1.60-3.84), 4.63 (2.92-7.35) and 4.22 (2.73-6.51), respectively, all P<0.001]. Pregnant women with a history of GDM with excessive GWG had an increased risk of preeclampsia ( OR=2.46, 95% CI: 1.10-5.51, P<0.05). During pregnancy: pregnant women with GDM history of different GWG categories had a higher risk of developing GDM [ OR and 95% CI were 3.02(2.00-4.59), 4.08(2.76-6.04) and 2.66(1.54-4.59) for inadequate, adequate and excessive GWG, respectively, all P<0.001]. Women with GDM history had an increased risk of large for gestational age (LGA) in those with inadequate GWG and postpartum hemorrhage in those with excessive GWG [ OR and 95% CI were 1.94 (1.09-4.21) and 2.93 (1.31-6.55), respectively, both P<0.05]. Conclusions:The total GWG and GWG in different periods during the second pregnancy in women with a history of GDM are lower than those without, but with a higher risk of adverse outcomes. Even in women with the same range of GWG, GDM history still increases the risk of adverse pregnancy outcomes.

8.
Article in Chinese | WPRIM | ID: wpr-885148

ABSTRACT

Objective:To analyze the epidemiological characteristics of human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co-infected patients in Beijing and investigate the associated factors.Methods:The clinical data of patients with HIV infection who were treated in HIV/AIDS designated hospitals (Peking Union Medical College Hospital, Beijing Ditan Hospital and Beijing Youan Hospital) were retrospectively analyzed.Results:A total of 11 572 patients were finally included in the study, among whom 532 patients (4.6%) were co-infected with HIV and HBV. Most of the co-infected patients were young male adults (28~48 years old), accounting for 85.9%. The main transmission route was homosexual behavior (74.8%). There were 87.4% co-infected patients treated with two anti-HBV drugs, including lamivudine (3TC) and tenofovir (TDF). From 2013 to 2018, the annual prevalence of HIV and HBV co-infection decreased gradually, with the rate of 6.37%, 4.55%, 3.92%, 4.68%, 4.24% and 2.74%, respectively. In our study, The main influencing factors of HIV and HBV co-infection were age older than 28 years old versus<28 years old ( OR=2.807, 95% CI 1.241-6.345) and marriage status (married versus unmarried, OR=1.259, 95% CI 1.004-1.579). Conclusions:The proportion of HBV infection in HIV-infected patients is 4.60% (532) in our cohort. From 2013 to 2018, the prevalence of HIV and HBV co-infection in Beijing shows a decreasing trend. The risk of co-infection is higher in married young adults (28~48 years old).

9.
Article in Chinese | WPRIM | ID: wpr-885111

ABSTRACT

To report the clinical, imaging, and pathological feature of a rare case of central precocious puberty with primary pigmented nodular adrenocortical disease(PPNAD), and to conduct a retrospective analysis of PPNAD with relevant literatures. The pubic hair was found in the child for more than one year. Physical examination showed Cushing′s syndrome. ACTH in blood decreased, cortisol rhythm was disordered, 24-hour urine free cortisol increased and the paradoxical increase of urine free cortisol after high dose dexamethasone suppression test. Adrenal enhancement computed tomography(CT)showed multiple small nodular shadows in bilateral adrenal glands. Gonadotropin releasing hormone(GnRH)stimulation test supported central precocious puberty and GnRH analogue was used to control the sexual development. PPNAD was supported by pathology result. The symptoms of Cushing′s syndrome were relieved partially after left adrenalectomy.

10.
Article in Chinese | WPRIM | ID: wpr-884570

ABSTRACT

Objective:To analyze the predicting values of hematological indicators for the pathological response in patients with gastric adenocarcinoma after preoperative neoadjuvant therapy and radical surgery.Methods:The absolute count of neutrophils (NE), lymphocytes (LY) and monocytes (MO) of 102 patients with locally advanced gastric adenocarcinoma in a multi-center randomized phase Ⅲ clinical trial (NCT01815853) from June 2013 to Feburary 2019 were retrospectively analyzed. Patients were divided into the chemotherapy alone group (ChT, 3 cycles of XELOX regimen) and the chemoradiation group (CRT, 1 cycle of induced XELOX regimen and 4500 cGy/25f radiotherapy plus concurrent extenuated 2 cycles of XELOX regimen), 51 cases in each group. The pathological response indicators of tumors after radical surgery included tumor regression grade, pathological complete regression, pathological T stage (ypT), N stage (ypN) and TNM stage (ypTNM).Results:Univariate regression analysis and ROC curves demonstrated a significant association between the absolute neutrophil count (NE) and ypT, lymphocyte-to-monocyte ratio (LMR) and ypN 0, and LMR and ypTNM reduction in the entire cohort of patients. Multivariate regression analysis showed that higher NE (>4.10×10 9/L) was significantly associated with higher probability of ypT reduction ( OR=3.308, P=0.007). Higher LMR (>3.46) was significantly associated with higher ypN 0 probability ( OR=4.276, P=0.005) and better ypTNM reduction ( OR=2.805, P=0.019). In subgroup analysis, higher NE (>4.10) was significantly correlated with higher probability of ypT reduction ( OR=3.750, P=0.030) in the CRT group, and higher LMR (>3.46) was significantly associated with higher ypN 0 probability ( OR=8.500, P=0.050) and the probability of ypTNM stage reduction ( OR=4.000, P=0.026) in the ChT group. Conclusions:Pretreatment NE and LMR in the peripheral blood serve as independent predictors for tumor pathological responses after preoperative treatment, and immune condition is correlated with tumor regression after radical surgery in patients with locally advanced gastric cancer.

11.
Article in Chinese | WPRIM | ID: wpr-884308

ABSTRACT

Objective:To analyze the diagnostic value of thickness ratio between noncompacted and compacted myocardium (NC/C ratio) measured by echocardiography at end-systole and end-diastole comparatively in left ventricular noncompaction (LVNC).Methods:Thirty-five patients with suspected LVNC were collected and underwent conventional (2DE) and left ventricular opacification (LVO) in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from June 2019 to June 2020. The distribution and detection rate of two-layered segments, non-compaction (NC) segments and their NC/C ratios were comparatively analyzed at end-diastole and end-systole using 2DE, LVO and combined techniques respectively. With the diagnostic criteria of end-diastolic NC/C ratio>2.3 or end-systolic NC/C ratio>2.0, echocardiographic results were also recorded and compared with cMRI results.Results:Compared with 2DE, the number of detected segments was increased ( P<0.001), but the numbers of two-layered segments and NC segments were not significantly improved in end-systole using 2DE combined with LVO ( P>0.006). The diagnostic accuracy was not statistically significant ( P>0.05). However, when observing in end-diastole, the detected numbers of 3 kinds of segments were significantly increased using 2DE+ LVO in comparison with 2DE (all P<0.001), and the diagnostic accuracy was also significantly improved ( P<0.05). There were no significant differences in the detected rates of two-layered and NC semgents between 2DE+ LVO and cMRI ( P>0.006). 2DE+ LVO in end-diastole resulted in the highest diagnostic sensitivity (88.9%) and accuracy (85.7%), and also the largest area under ROC curve (0.95). Conclusions:The combination of 2DE and LVO can detect more NC segments, and diagnostic accuracy of end-diastolic NC/C ratio is higher than that in end-systolic in patients with LVNC.

12.
Article in Chinese | WPRIM | ID: wpr-884182

ABSTRACT

Objective:To assess the value of CD4 + and CD8 + T-lymphocyte counts for the diagnostic classification and prognosis of coronavirus disease 2019 (COVID-19). Methods:A total of 95 COVID-19 adult patients admitted to Shanghai Public Health Clinical Center, Fudan University from January to March 2020 were recruited. The CD4 + and CD8 + T-lymphocyte counts among ordinary, severe and critical patients, as well among the cured, improved, unimproved and death patients were compared. The area under receiver operating characteristic curve (AUROC) was used to evaluate the value of CD4 + and CD8 + T-lymphocyte counts for the clinical diagnosis and prognosis of COVID-19. The comparison among groups was performed by Mann-Whitney U test. Results:A total of 95 COVID-19 cases including 68 common, 11 severe and 16 critical cases were enrolled. The counts of CD4 + and CD8 + T-lymphocyte of patients in common, severe and critical groups were 419 (309, 612), 267 (212, 540), 141 (77, 201)/μL, and 238 (153, 375), 128 (96, 172), 92 (51, 144)/μL, respectively, with significant differences ( Z=24.322 and 15.956, respectively, both P<0.01). The counts of CD4 + and CD8 + T-lymphocyte of the death, unimproved, improved, and cured patients were 149 (143, 349), 315 (116, 414), 344 (294, 426), 745 (611, 966)/μL, and 106 (43, 501), 176(67, 279), 194(188, 432), 429(276, 564)/μL, respectively, with significant differences ( Z=36.083 and 16.658, respectively, both P<0.01). The optimal cut-off point of CD4 + T-lymphocyte counts was 237/μL for critical COVID-19 with AUROC 0.911 (95% confidence interval ( CI) 0.833-0.989, P<0.01), with the sensitivity of 86.1% and specificity of 87.5%. For predicting severe and critical cases, the optimal cut-off point of CD4 + T-lymphocyte counts was 405/μL with AUROC 0.863 (95% CI 0.727-0.999, P=0.001), with the sensitivity of 78.6% and specificity of 74.6%. Conclusions:The conditions of patients with COVID-19 are aggravated with CD4 + and CD8 + T-lymphocyte counts decreasing. CD4 + T-lymphocyte counts may be an indicator for diagnostic classification of COVID-19 and prognostic indicator for severe and critical patients.

13.
Journal of Chinese Physician ; (12): 502-505, 2021.
Article in Chinese | WPRIM | ID: wpr-884078

ABSTRACT

Objective:The purpose of our study was to assess the clinical value of ultrasound in the diagnosis of retroaortic left renal vein (RLRV) behind abdominal aorta.Methods:The ultrasound images of patients with RLRV diagnosed by ultrasound in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from 2013 to 2018 were retrospectively analyzed. The general information, clinical symptoms, ultrasound images and other clinical data of the patients were collected and analyzed.Results:RLRV was detected in 16(0.46%) cases of the 3 519 patients from 2013 to 2018 using ultrasonography, and the male to female ratio was 11 to 5. All patients presented with hematuria, including 7 patients with other symptoms, such as left flank pain. Ultrasound were firstly performed in all patients. Of the 16 patients, 15(93.75%) cases were of complete retroaortic type Ⅰ, including 13(81.25%) cases with left renal vein compression and 2(12.5%) cases with complete retroaortic type without left renal vein compression. In 16 cases, 1 case (6.25%) was type Ⅲ, with compression of both branches.Conclusions:Ultrasound may be the preferred method for the left renal vein examination when a clinical suspicion of Nutcracker syndrome is required. Ultrasound can clearly show the left renal vein in most patients, to determine whether the left renal vein is mutated or compressed. Ultrasound has the highest sensitivity for detecting the type Ⅰ, which is not easy to misdiagnose. However, type Ⅲ is easy to misdiagnosis. Whereas the type Ⅱ and type Ⅳ is difficult to detect using ultrasound, which may be related to the limitations of ultrasound imaging.

14.
Journal of Chinese Physician ; (12): 497-501, 2021.
Article in Chinese | WPRIM | ID: wpr-884077

ABSTRACT

Objective:To investigate the ultrasonographic features of internal jugular venous vein pseudo-aneurysm.Methods:The ultrasonographic and clinical features of a patient with internal jugular venous vein pseudo-aneurysm in Union Hospital Affiliated to Huazhong University of Science and Technology were retrospectively analyzed. These characteristics of this patient combined with cases from literatures were summarized.Results:Ultrasound showed that the 38.6 mm×14.0 mm×29.9 mm anechoic area in the soft tissue layer of the left neck communicated with the left internal jugular vein through the 3.8 mm wide breach, and a 12.9 mm×6.6 mm slightly hyperechoic mass was found in the anechoic area. Color Doppler flow imaging showed that the internal jugular vein communicated with the anechoic area through the crevasse. There was no obvious blood flow signal in slightly hyperechoic mass. The bidirectional burr-like blood flow signal could be detected by pulse-wave Doppler. Contrast enhanced ultrasound showed that the contrast agent flowed into the mass from the internal jugular vein through the breach, and the slightly hyperechoic mass appeared the contrast filling defect, and contrast agent was well filled in the rest of the anechoic area. Ultrasound diagnosis: left internal jugular vein pseudoaneurysm with thrombosis. 35 cases of cervical vein pseudo-aneurysm patients were finally included in 23 documents, including 12 males, 23 females, 15 cases on the left side, 20 cases on the right side, 6 cases of the internal jugular vein, 27 cases of the external jugular vein; one case only describes the neck veins and supraclavicular vein in another one case. Among them, 34 cases showed subcutaneous anechoic masses on ultrasound, 1 case showed slightly hyperechoic masses, and 35 cases showed venous wall breaches.Conclusions:Ultrasound examination has high diagnostic value for vein pseudo-aneurysm owing to its convenience, fast and serial observation. Therefore, it is the preferred method and can be widely used in clinical practice. Contrast-enhanced ultrasound can clearly show the blood perfusion, and help to improve the diagnostic confidence of the operator.

15.
Journal of Chinese Physician ; (12): 493-496,501, 2021.
Article in Chinese | WPRIM | ID: wpr-884076

ABSTRACT

Objective:To investigate the clinical value of conventional ultrasound combined with contrast-enhanced ultrasound (CEUS) in diagnosis of chromophobe renal cell carcinoma (ChRCC).Methods:We retrospectively analyzed the ultrasound features of 40 cases with ChRCC which were confirmed by operation and pathology from January 2012 to January 2018 in our hospital. The site, shape, size, capsule, internal echo and blood supply of the lesions were observed by routine ultrasound. Then CEUS showed the modality of enhancement, including the arrival time, peak time, peak intensity, distribution and the washout time.Results:Among the 40 cases, 38 cases were single, 2 cases were multiple, 17 cases were left kidney, 22 cases were right kidney, 1 case was double kidney. The tumors were located in the upper part of the kidney in 8 cases (20.0%), the lower part of the kidney in 9 cases (22.5%), and the middle part of the kidney in 23 cases (57.5%). One of the tumors was located in the right renal pelvis, and the lesion invaded the renal capsule in 11 cases (27.5%). The tumor was round, quasi round or oval, with clear boundary in 35 cases (87.5%), unclear boundary in 5 cases (12.5%), and the maximum diameter was 2.0-11.2 (5.1±0.8)cm. The lesions were hypoechoic in 23 cases (57.5%), isoechoic in 7 cases (17.5%), slightly hyperechoic in 7 cases (17.5%), cystic and solid mixed echo in 3 cases (7.5%), homogeneous echo in 23 cases (57.5%), heterogeneous echo in 17 cases (42.5%), and calcification in 5 cases (12.5%). Color Doppler flow imaging (CDFI) showed that blood vessels could be seen around the lesions, and no obvious blood flow signal was detected in 15 cases (37.5%) of the lesions; few star shaped blood flow signals could be detected in 12 cases (30%) of the lesions, short strip shaped blood flow signals could be detected in 7 cases (17.5%) of the lesions, and abundant blood flow signals could be seen in 6 cases (15%) of the lesions. Four patients underwent contrast-enhanced ultrasound examination at the same time. The lesions began to strengthen rapidly and evenly at the same time in the renal cortex, showing slightly low enhancement, and disappeared earlier than the renal cortex, showing a " fast forward and fast backward" perfusion mode. No tumor thrombus in draining vein, perirenal tissue and lymph node metastasis were found in all cases.Conclusions:Conventional ultrasound show ChRCC to be poor blood supply of solid tumors in the renal parenchyma, most of which are hypoechoic or isoechoic, with clear boundaries. CEUS show the lesions taking on high wash-in and wash-out, low enhancement than the surrounding renal cortex. These features are helpful for preoperative ultrasound diagnosis of ChRCC.

16.
Journal of Chinese Physician ; (12): 488-492, 2021.
Article in Chinese | WPRIM | ID: wpr-884075

ABSTRACT

Objective:This study aimed to investigate the relationships between anthropometric parameters and carotid elasticity by real-time vascular quantification stiffness technique (R-VQS), and to identify the predictive value of anthropometric parameters for cardiovascular disease risk.Methods:A total of 563 adults were recruited for this study and were divided into two groups by gender. The anthropometric indices [body mass index (BMI), waist circumference (WC), a body shape index (ABSI), body round index (BRI), and visceral adiposity index (VAI)] were calculated. R-VQS technique was used to assess the parameters of carotid elasticity: pulse wave velocity (PWV). The correlations between the anthropometric indices and PWV were analyzed. Linear regression was used to analyze the predictive factors of PWV.Results:⑴ The BMI, WC, ABSI, BRI, VAI and PWV were higher in men than those in women ( P<0.05); ⑵ In men and women, all the anthropometric parameters positively correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TG), and negatively correlated with high-density lipoprotein (HDL) ( P<0.05); ⑶ diabetes mellitus (DM) and hypertension history were predictors of PWV in men ( β=0.110, 0.101, respectively, P<0.05); DM, hypertension history and smoking status were predictors of PWV in women ( β=0.061, 0.095, 0.067, respectively, P<0.05); ⑷ After adjusting for diabetes, hypertension and smoking, ABSI and VAI were predictors of PWV in men ( β=0.078, 0.068, P<0.05); BMI, WC, ABSI, BRI and VAI were predictive factors of carotid PWV in women ( β=0.131, 0.123, 0.204, 0.153, 0.196, P<0.05). Conclusions:Among the anthropometric indexes, ABSI and VAI have good correlations with carotid elasticity in wen and women, represented by PWV. These results suggest that ABSI and VAI may be convenient, highly cost-effective and simple parameters for obesity and are associated with cardiovascular disease (CVD) risk in clinical practice. R-VQS is a convenient, real-time and rapid technique for the early assessment of the carotid elasticity.

17.
Journal of Chinese Physician ; (12): 484-487, 2021.
Article in Chinese | WPRIM | ID: wpr-884074

ABSTRACT

In recent years, ultrasound elastography, as a new technique for evaluating soft tissue elasticity, has been progressively used in musculoskeletal system. Shear-wave elastography (SWE) is considered to be more objective, quantitative, and reproducible than other ultrasonic elastography techniques with increasing applications to the musculoskeletal system. A number of studies have shown that SWE has high application value in determining severity and prognosis of the musculoskeletal tissue diseases (including tendons, muscles, nerves and ligaments). This article describes the applications of SWE in the evaluation of musculoskeletal system.

18.
Article in Chinese | WPRIM | ID: wpr-883926

ABSTRACT

Objective:To detect the potential biomarkers in the serum of adolescents with depressive disorder and provide the basis for clinical diagnosis of depression.Methods:A total of 45 adolescents with depression who met the inclusion criteria and 47 healthy controls (HC group) were screened.Patients with depression were treated with sertraline (100 mg/d) for 4 weeks.The patients before sertraline treatment were called DN-MDD group and then were called DT-MDD group after sertraline treatmant.Hamilton Depression Scale (HAMD) was used to evaluate the efficacy of the two groups before and after treatment.The serum was collected for UPLC-MS/MS to determine the changes in profiles of endogenous metabolites.And the software of SPSS 21.0, XCMS and Analyst 3.0 were used to analyze the data.The reliability and feasibility of clinical diagnosis were further analyzed by ROC via GraphPad 8.0.Results:After 4 weeks of sertraline treatment, the patients' HAMD score decreased (before: 19.71±1.72, after: 15.36±1.91) and the effective rate reached 51% ( P<0.01). Multivariate statistical analysis showed that HC group and DN-MDD group and DT-MDD group had significant differences in metabolic profile.Compared with healthy controls, 11 different metabolites were found in the plasma of DN-MDD group including glycerate, adenosine, creatine and so on.After treatment, concentrations of glucose, glutamate, aspartate, sucrose, creatine, pyruvate and adenosine were significant changes in serum of adolescent depression patients.Area under ROC curve of glucose and glutamic acid were >0.9, and the AUC of aspartic acid, sucrose, creatine, pyruvate and adenosine were >0.7, suggesting that these 7 metabolites had different degrees of diagnostic ability. Conclusion:There are different metabolic profiles between adolescents with or without depression, and the antidepressant sertraline is helpful to maintain the level of substance metabolism which can be used as one of the treatment methods for adolescent depression.Our research may support the new strategy for clinical diagnosis and treatment of adolescent depression.

19.
Article in Chinese | WPRIM | ID: wpr-883776

ABSTRACT

Objective:To investigate the effects of ultrasound-guided intervention with methotrexate combined with lauromacrogol on uterine wall thickness and menstrual recovery time in patients with uterine scar pregnancy.Methods:Sixty patients with uterine scar pregnancy who received treatment in Jinhua Wenrong Hospital, Jinhua Central Hospital, and Yiwu Maternity and Children Hospital from February 2019 to February 2020 were included in this study. They were randomly assigned to receive either uterine artery embolization treatment ( n = 30, control group) or ultrasound-guided interventions with methotrexate combined with lauromacrogol ( n = 30, study group). The success rate of treatment, uterine wall thickness at the scar, menstrual recovery time, hospitalization time, hospitalization expenses, incidence of adverse reactions, serum levels of beta-human chorionic gonadotropin (β-HCG) and high sensitivity C-reactive protein (hs-CRP) after 7 days of treatment and uterine wall thickness before and after treatment were compared between the study and control groups. Results:After treatment, the success rate of treatment in the study group was significantly higher than that in the control group [96.67% (29/30) vs. 70.00% (21/30), χ 2 = 7.680, P < 0.05]. Before treatment, there were no significant differences in β-HCG and hs-CRP levels between the control and study groups ( t = -0.197, 0.197, both P > 0.05). After treatment, serum level of β-HCG in the control and study groups was significantly decreased ( t = 22.803, 10.233, both P < 0.01), and serum level of hs-CRP in the control and study groups was significantly increased ( t = -16.357, 7.854, both P < 0.001) compared with before treatment. After treatment, there were no significant differences in serum β-HCG and hs-CRP levels between the control and study groups ( t = 20.413, -20.306, both P < 0.05). After treatment, the incidence of adverse reactions in the study group was significantly lower than that in the control group [6.67% (2/30) vs. 30.00% (9/30), χ 2 = 5.455, P < 0.05). After treatment, menstrual recovery time, hospitalization time and hospitalization expenses in the study group were shorter or less than those in the control group ( t = 5.080, 5.398, 7.599, all P < 0.05). There was no significant difference in the thickness of uterine wall at the scar site between the two groups ( t = -1.045, P > 0.05). Conclusion:Ultrasound-guided intervention with methotrexate combined with lauromacrogol for treatment of uterine scar pregnancy can effectively increase the success rate of treatment, promote the restoration of menstruation, shorten the length of hospital stay, and is highly safe.

20.
Chinese Journal of Endemiology ; (12): 414-418, 2021.
Article in Chinese | WPRIM | ID: wpr-883737

ABSTRACT

Objective:To evaluate the effect of health education project on prevention and control of endemic diseases in Henan Province.Methods:According to the distribution and condition of endemic diseases in Henan Province, from 2008 to 2015, five project counties (cities, districts, referred to as counties) were selected in each provincial city. Three townships (towns) were selected from each project county as project townships (towns), and one central primary school and the village where the school was located were selected from each township (town) as health education survey sites. The prospective study method was adopted. Firstly, the students in the primary school of the project township (town) and the housewives in the project village were investigated with questionnaire. The intervention activities of health education were carried out in the county, township (town), village and school of the project. The intervention effect of health education was evaluated by questionnaire survey two months later.Results:There were 111 870 people investigated in Henan Province, including 74 580 students and 37 290 housewives. A total of 99 671 people were surveyed after the intervention, including 66 249 students and 33 422 housewives. Elementary student's awareness rate of endemic diseases prevention and control knowledge increased from 59.74% before intervention to 92.89% after intervention, the housewives' awareness rate increased from 65.62% before intervention to 91.82% after intervention. The awareness rate of the target population increased from 61.70% before intervention to 92.53% after intervention ( P < 0.01); among them, the awareness rates of iodine deficiency disorders, drinking water type fluorosis, coal-burning type fluorosis, drinking water type arsenic poisoning, Kashin-Beck disease and Keshan disease were significantly increased ( P < 0.01). Conclusion:With the implementation of health education project, the awareness rate of knowledge on endemic diseases has increased distinctly.

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