Diagnostic analysis of primary hepatic lymphoepithelioma-like carcinoma on contrast-enhanced ultrasound / 中华超声影像学杂志

Objective:To retrospectively analyze the contrast-enhanced ultrasound(CEUS) features of primary hepatic lymphoepithelioma-like carcinoma (LELC) and investigate the value of CEUS in the diagnosis of hepatic LELC.Methods:The images of CEUS of 12 cases with hepatic LELC were retrospectively analyzed. The perfusion patterns and time of enhancement were observed.Results:During the arterial phase, 11 lesions showed diffuse enhancement, while 1 lesion showed rim-like enhancement. The mean time of begin enhancement, time to peak, time to iso-enhancement and slightly hypo-enhancement were (17.92±5.81)s, (24.50±5.52)s, (29.55±6.25)s, (45.50±25.15)s, respectively. Compared with adjacent liver parenchyma, rapid enhancement was observed in 11 lesions and synchronous enhancement was observed in 1 lesion.As to time of peak enhancement, hyper-enhancement and iso-enhancement were observed in 11 lesions and 1 lesion, respectively. In portal phase, 8 lesions manifested slight hypo-enhancement, 3 lesions with marked hypo-enhancement and 1 lesion with iso-enhancement.And in delayed phase, 10 lesions showed marked hypo-enhancement and 1 lesion with slight hypo-enhancement. Ten lesions showed peripheral hyper-enhancement like a bright ring in the portal and delayed phase.Conclusions:CEUS is valuable for the diagnosis and differential diagnosis of hepatic LELC.

Accuracy of dexmedetomidine titration in diagnosis of restless legs syndrome / 中华麻醉学杂志

The medical records of patients of both sexes with sleep disorders treated with multimodal sleep therapy for which patient controlled sleep with dexmedetomidine was the main method, aged≥18 yr, with body mass index of 18-30 kg/m 2, from February 2019 to January 2021, were collected.Dexmedetomidine 60 ml/h (4 μg/ml) was intravenously infused until non-rapid eye movement (NREM) Ⅲ phase was reached or the consumption of dexmedetomidine reached 1 μg/kg.Whether dexmedetomidine induced restless legs syndrome (RLS) was judged according to the Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition). When the titration was stopped and on the next day after emergence from anesthesia, clinical diagnosis was performed according to Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition) to determine whether RLS was combined or not.Kappa consistency analysis was used to assess the consistency between dexmedetomidine titration and the Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 Edition) in diagnosis of RLS.The sensitivity and specificity of diagnosis of RLS by dexmedetomidine titration were calculated.A total of 39 patients were included and 8 patients had RLS symptoms which were judged accroding to dexmedetomidine titration.The results of Kappa consistency test showed that there was a strong consistency between dexmedetomidine titration and Chinese guidelines for the diagnosis and treatment of restless legs syndrome (2021 edition) (Kappa value 1.0, P<0.01). The sensitivity and specificity of dexmedetomidine titration in judging RLS were 100%.In conclusion, dexmedetomidine titration can accurately judge RLS.

Prevalence characters of peripheral artery disease and associated factors among Beijing residents aged equal and above 35 years old / 中华心血管病杂志

Objective@#To investigate the prevalence characters of peripheral artery disease (PAD) and associated factors among people aged 35 and above in Beijing.@*Methods@#This was a cross-sectional study. A total of 5 208 community-based individuals aged equal and above 35 in Beijing were chosen with stratified multistage random sampling method. Structure questionnaire was used to collected the information of demographic factors, habits and chronic disease history. Ankle brachial blood pressure was detected and ankle brachial index (ABI) was calculated. ABI was used to diagnose PAD (ABI≤0.90). Based on the 2010 Beijing Municipal Population Census, the age-and gender-specific weight-adjusted sample was acquired to estimate the prevalence of PAD and corresponding 95% confidence intervals (CI). Multivariate logistic regression analysis was performed to estimate the associated factors of PAD.@*Results@#The age-and sex-standardized prevalence of PAD was 3.84% (200/5 208, 95%CI 3.32%-4.36%). There was no significant difference between male and female (3.83%(102/2 664, 95%CI 3.10%-4.56%) vs. 3.85% (98/2 544, 95%CI 3.10%-4.60%), P=0.965). The prevalence of PAD in urban was higher than that in rural (4.34% (163/3 755, 95%CI 3.69%-4.99%) vs. 2.55% (37/1 453, 95%CI 1.74%-3.36%), P=0.001). Furthermore, the prevalence of PAD increased with age (Ptrend<0.01), and the difference between genders did not change with ageing (all P>0.05). In addition, age (OR=1.03, 95%CI 1.01-1.04), urban (OR=1.52, 95%CI 1.08-2.12), smoking (OR=1.83, 95%CI 1.29-2.59), hypertension (OR=1.61, 95%CI 1.17-2.22) and diabetes (OR=1.44, 95%CI 1.08-1.93) were related with increased risk of PAD in logistic regression analysis models.@*Conclusions@#The prevalence of PAD increases with age in Beijing and there are significant difference between urban and rural on prevalence of PAD. Age, urban, smoking, hypertension and diabetes are related with increased risk of PAD.