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Objective ToinvestigatetheMSCTfeaturesanditsclinicalvalueofcoronaryarteryfistula(CAF)withsurgicalindication. Methods CTfindingsof36patientswithluminaltumorGlikedilationCAFprovedbysurgerywereanalyzedretrospectively.Bymeans ofMIP,CPR,MPRandVRreconstruction,wearrangedtheabnormalvesselsintogroupsaccordingtoitscharacteristics,andmeasured thediameterofdilatation.ThediagnosticaccuracyofMSCTforCAFwascomparedwithtransthoracicechocardiography.Results Among the36cases,drainagesitesof8caseswererightatrium,14casesrightventricle,2casespulmonaryartery,1caseleftatrium,9cases leftventricle,and2casescoronarysinus.Amongallcases,4casesoriginatedfromleftmainartery,2casesfromleftanteriordescending, 5casesfromcircumflexartery,and25casesfromrightCAF.Ofwhich,24casesunderwentfistulaligationwithextracorporealcirculation. 12casesweretreatedwithminimallyinvasivesurgery.ThediagnosticaccuracyofMSCTbeforesurgerywas100%(36/36),andthat ofechocardiographywasabout80.6%(29/36).Conclusion ReconstructiontechniqueofMSCTcanprovidetheinformationofthe CAFvesselsanditsorigin,courseandshapeoffistulaorificium.MSCTcanaccuratelylocateandguidethesurgicalapproach,especially forpreGinvasivesurgery,providingimportantinformationfortreatment.MSCTshouldbethebestimagingmethodforCAF.
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Objective To compare the efficacy of endoscopic sphincterotomy ( EST) combined with large-balloon dilation ( LBD) and that of LBD alone for large bile duct stones. Methods Data of 61 patients who received EST combined with LBD ( the combination group ) and 48 patients who received LBD alone ( the LBD group) from February 2008 to November 2014 were collected. The efficacy and adverse events of two groups were compared. Results The procedure time from successful cannulating to complete stone removal was shorter in the LBD group than that in the combination group [ 17. 3 min ( 8-35 min ) VS 21. 5 min ( 10-42 min) , P=0. 041] . There were no significant differences in overall complete stone removal rate[90. 2％ (55/61) VS 91. 7％ (44/48), P=1. 000] and complete stone removal rate without mechanical lithotripsy[78. 7％ (48/61) VS 83. 3％ (40/48), P=0. 542] in the combination group and the LBD group. Massive bleeding occurred in one patient of the combination group, but was successfully coagulated under endoscopy. There was no significant difference in the incidence of postoperative pancreatitis between the two groups[4. 9％ (3/61) VS 6. 3％ (3/48), P=1. 000]. Conclusion EST combined with LBD offers no significant advantage over LBD alone for the removal of large bile duct stones. LBD can simplify the procedure compared with EST combined with LBD in terms of shortening the procedure time.
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Objective To study the mechanism of activity change of gastric alcohol dehydrogenases(ADH).We investigated ADH before and after ingestion of alcohol on rats.Methods Thirty-nine rats were divided into two groups at random:model ones(24 cases) and control ones(15 cases).Model group of rats were infused into stomaches by alcohol,and control ones by distill water.Structures of cell and sub-cell in gastric mucous membrane were observed by enzyme electron microscope and hematoxylin eosin(HE) stain.Results It was shown that there were dropsical degeneration of chief cells and parietal cells of stomaches by HE stain,and the mitochondria of parietal cells and the rough-surfaced endoplasmic reticulum(rER) of chief cells were destroyed by enzyme electron microscope in model groups after two months of ethanol perfusion.There were not change in control group.Conclusions The mechanism of activity alterations of gastric ADH may result from dropsical degeneration of chief cells and parietal cells of stomach,which result in degeneration,solution and breakage of construction of rER in the chief cells and mitochondria in parietal cells.