Proton magnetic resonance spectroscopy in the evaluation of infiltration zone of cerebral alveolar echinococcosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cerebral alveolar echinococcosis (CAE) grows infiltratively like a malignant tumor, causing great harm to the human body. It is possible to display mass lesions of CAE using various imaging systems, but regarding the infiltrating proliferation active regions, it is difficult to evaluate its actual range using conventional magnetic resonance imaging (cMRI). This research focused on proton magnetic resonance spectroscopy ((1)HMRS) techniques to find the mass and infiltration zone of CAE. We explored the marginal zone (MZ) of CAE nearly close to the actual infiltrating scope, to provide reliable images for clinical purposes, to overcome shortcomings of cMRI, to formulate beneficial clinical surgical plans and assess prognosis.</p><p><b>METHODS</b>Between September 2005 and May 2011, 15 patients who were suffering from CAE (36 effective lesions altogether) were examined by (1)HMRS at the first affiliated hospital of Xinjiang Medical University. Multi-voxel (1)HMRS was acquired with a 1.5T MRI scanner. Concentrations and the ratios of the metabolites of CAE were calculated. Furthermore, changes in the concentrations of the metabolites containing N-acetyl-aspartic-acid (NAA), choline (Cho), creatine (Cr), lipids and lactate (Lip + Lac) and the ratios of Cho/Cr, NAA/Cr, (Lip + Lac) /Cr were compared in the substantial region, 0 - 10 mm MZ, and 11 - 20 mm MZ of the infiltration zone, as well as the corresponding contralateral part of the normal brain parenchyma area (control group).</p><p><b>RESULTS</b>In this study, the ratios of Cho/Cr in the substantial region, 0 - 10 mm MZ of infiltration zone and the control group were 1.78 ± 0.70, 1.90 ± 0.54, and 0.78 ± 0.15, respectively; the ratios of NAA/Cr were 1.60 ± 0.20, 1.80 ± 0.42, 2.24 ± 0.86, respectively; the ratios of (Lip + Lac)/Cr were 25.69 ± 13.84, 25.18 ± 16.03, and 0.61 ± 0.15, respectively. From the control group, 11 - 20 mm MZ to 0 - 10 mm MZ and the substantial region of CAE, the concentrations of the metabolites showed that NAA and Cho decreased gradually and markedly. But (Lip + Lac) increased gradually and markedly. The ratios of Cho/Cr and NAA/Cr, (Lip + Lac)/Cr were statistically significant (P < 0.0083) between the substantial region and the control group, as well as between the 0 - 10 mm MZ and the control group. The ratios of Cho/Cr and NAA/Cr, (Lip + Lac)/Cr displayed no statistically significant differences (P > 0.0083) between the substantial region and the 0 - 10 mm MZ.</p><p><b>CONCLUSIONS</b>There was a pathological spectrum surrounding the infiltration zone of CAE. Multi-voxel 1HMRS has great clinical value for discerning the main lesion and the infiltration zone of CAE.</p>

Function of portal pressure during operation on the choice of surgical approaches in portal hypertension / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between perioperative free portal pressure (FPP) after devascularization or spleno-renal shunt operation added devascularization and rebleeding or encephalopathy in patients with portal hypertension, and evaluate the relationship between dynamic changes of FPP and surgical approaches.</p><p><b>METHODS</b>The clinical data of 170 patients with portal hypertension receiving devascularization or devascularization with spleno-renal shunt operation (combination group) from January 2001 to December 2007 were retrospectively analyzed. All patients were divided into three groups: low pressure group [L group, after devascularization FPP <or= 22 mm Hg (1 mm Hg = 0.133 kPa), n = 43], high pressure group (H group, FPP > 22 mm Hg, n = 60) and combination group (C group, n = 47). There was no significant difference in preoperative Child-Pugh score and pre-operation FPP (P > 0.05) among the three groups. Perioperative FPP, morbidity of rebleeding and encephalopathy were compared with each other.</p><p><b>RESULTS</b>The values of postoperative FPP were (27.1 +/- 1.9) mm Hg, (20.8 +/- 1.8) mm Hg and (21.5 +/- 2.2) mm Hg among the H group, L group and C group respectively. The rebleeding rates were 21.7%, 4.6% and 4.5% among the three groups respectively. All the values in H group were higher than those in L group and C group remarkably. The encephalopathy rate in C group (10.4%) was higher than that in L group (7.0%) or H group (3.3%), but there were no statistical significance (P > 0.05).</p><p><b>CONCLUSIONS</b>FPP after splenectomy and devascularization may be a basis of choice of surgical approaches in portal hypertension. The spleno-renal shunt operation should be performed in the patients when FPP is over 22 mm Hg after devascularization.</p>

Clinical study of macular retinoschisis / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To improve our understanding of retinoschisis at the macular area.·METHODS: From January 2003 to January 2005, the patients whose macular retinoschisis was confirmed by optical coherence tomography (OCT) were included in the study. Their data and other results were further analyzed.·RESULTS: During that period, macular retinoschisis was found in 116 eyes which fit the including criteria. Among these, 94 eyes were pathological myopia; 17 were X-linked congenital retinoschisis; and 5 had excavation of optic disk.By analyzing the OCT figures, it was found that retinoschisis could happen at many locations within retinal neural epithelium, including inner, middle and outer part. The retinoschisis caused by different reasons differs in OCT results.·CONCLUSION: Retinoschisis at the macular area was not rare at the clinic, and the retinoschisis may be located at different parts of the retina. OCT was useful in the diagnosis and follow-up of macular retinoschisis.