Two-Dimensional Shear Wave Elastography Predicts Liver Fibrosis in Jaundiced Infants with Suspected Biliary Atresia: A Prospective Study

Objective@#This study aimed to evaluate the role of preoperative two-dimensional (2D) shear wave elastography (SWE) in assessing the stages of liver fibrosis in patients with suspected biliary atresia (BA) and compared its diagnostic performance with those of serum fibrosis biomarkers. @*Materials and Methods@#This study was approved by the ethical committee, and written informed parental consent was obtained. Two hundred and sixteen patients were prospectively enrolled between January 2012 and October 2018. The 2D SWE measurements of 69 patients have been previously reported. 2D SWE measurements, serum fibrosis biomarkers, including fibrotic markers and biochemical test results, and liver histology parameters were obtained. 2D SWE values, serum biomarkers including, aspartate aminotransferase to platelet ratio index (APRi), and other serum fibrotic markers were correlated with the stages of liver fibrosis by METAVIR. Receiver operating characteristic (ROC) curves and area under the ROC (AUROC) curve analyses were used. @*Results@#The correlation coefficient of 2D SWE value in correlation with the stages of liver fibrosis was 0.789 (p < 0.001). The cut-off values of 2D SWE were calculated as 9.1 kPa for F1, 11.6 kPa for F2, 13.0 kPa for F3, and 15.7 kPa for F4. The AUROCs of 2D SWE in the determination of the stages of liver fibrosis ranged from 0.869 to 0.941. The sensitivity and negative predictive value of 2D SWE in the diagnosis of ≥ F3 was 93.4% and 96.0%, respectively. The diagnostic performance of 2D SWE was superior to that of APRi and other serum fibrotic markers in predicting severe fibrosis and cirrhosis (all p < 0.005) and other serum biomarkers. Multivariate analysis showed that the 2D SWE value was the only statistically significant parameter for predicting liver fibrosis. @*Conclusion@#2D SWE is a more effective non-invasive tool for predicting the stage of liver fibrosis in patients with suspected BA, compared with serum fibrosis biomarkers.

Two-Dimensional Shear Wave Elastography Predicts Liver Fibrosis in Jaundiced Infants with Suspected Biliary Atresia: A Prospective Study

Objective@#This study aimed to evaluate the role of preoperative two-dimensional (2D) shear wave elastography (SWE) in assessing the stages of liver fibrosis in patients with suspected biliary atresia (BA) and compared its diagnostic performance with those of serum fibrosis biomarkers. @*Materials and Methods@#This study was approved by the ethical committee, and written informed parental consent was obtained. Two hundred and sixteen patients were prospectively enrolled between January 2012 and October 2018. The 2D SWE measurements of 69 patients have been previously reported. 2D SWE measurements, serum fibrosis biomarkers, including fibrotic markers and biochemical test results, and liver histology parameters were obtained. 2D SWE values, serum biomarkers including, aspartate aminotransferase to platelet ratio index (APRi), and other serum fibrotic markers were correlated with the stages of liver fibrosis by METAVIR. Receiver operating characteristic (ROC) curves and area under the ROC (AUROC) curve analyses were used. @*Results@#The correlation coefficient of 2D SWE value in correlation with the stages of liver fibrosis was 0.789 (p < 0.001). The cut-off values of 2D SWE were calculated as 9.1 kPa for F1, 11.6 kPa for F2, 13.0 kPa for F3, and 15.7 kPa for F4. The AUROCs of 2D SWE in the determination of the stages of liver fibrosis ranged from 0.869 to 0.941. The sensitivity and negative predictive value of 2D SWE in the diagnosis of ≥ F3 was 93.4% and 96.0%, respectively. The diagnostic performance of 2D SWE was superior to that of APRi and other serum fibrotic markers in predicting severe fibrosis and cirrhosis (all p < 0.005) and other serum biomarkers. Multivariate analysis showed that the 2D SWE value was the only statistically significant parameter for predicting liver fibrosis. @*Conclusion@#2D SWE is a more effective non-invasive tool for predicting the stage of liver fibrosis in patients with suspected BA, compared with serum fibrosis biomarkers.

Influence of modified catheter thrombolytic regimen on clinical efficacy and safety of patients with acute DVT / 中国基层医药

Objective:To investigate the influence of modified catheter thrombolytic regimen on clinical efficacy and safety of patients with acute deep vein thrombosis (DVT).Methods:From March 2016 to March 2018, 86 patients with acute DVT were chosen in the Central Hospital of Yuncheng and randomly divided into two groups by random drawing method, with 43 cases in each group.The control group received routine catheter thrombolytic regimen, and the observation group received modified catheter thrombolysis regimen.The postoperative detumescence rate, postoperative lower limb circumference difference, venous patency score before and after operation, postoperative venous patency rate, operation time, thrombolytic costs, urokinase dosage, reduction amount of hemoglobin after operation and incidence of complications after operation of the two groups were compared.Results:There were no statistically significant differences in the postoperative detumescence rate, postoperative lower limb circumference difference, venous patency score after operation, postoperative venous patency rate between the two groups[(81.52±3.05)% vs.(84.66±4.29)%; (1.10±0.34)cm vs.(1.24±0.39)cm; (2.40±0.53)points vs.(2.51±0.59)points; (63.16±6.98)% vs.(64.81±7.15)%; t=0.58, 0.70, 0.16, 0.25, all P>0.05]. The operation time and reduction amount of hemoglobin after operation of the observation group were significantly more than those of the control group[(42.81±6.17)min vs.(20.86±3.02)min; (12.84±3.96)g/L vs.(4.13±1.02)g/L; t=4.26, 3.51, P<0.05]. The thrombolytic costs and urokinase dosage of the observation group were significantly less than those of the control group[(4 129.25±584.57)CNY vs.(7 251.49±695.70)CNY; (79.17±10.79)×10 4U vs.(217.13±38.76)×10 4U; t=7.14, 10.26, all P<0.05]. There was no statistically significant difference in the incidence of complications after operation between the two groups (11.63% vs.9.30%, χ 2=0.82, P>0.05). Conclusion:Compared with routine catheter thrombolytic regimen, modified catheter thrombolytic regimen in the treatment of patients with acute DVT has the same clinical effects and safety, and can efficiently reduce the treatment costs and the urokinase dosage, but may also increase the operation time and bleeding volume.

Influence of different types of balloon dilatation on clinical efficacy and safety in patients with lower extremity arteriosclerosis obliterans / 中国医师进修杂志

Objective:To investigate the influence of plain old balloon angioplasty (POBA) and drug-coated balloon (DCB) dilatation on clinical efficacy and safety in patients with lower extremity arteriosclerosis obliterans.Methods:Seventy patients with lower extremity arteriosclerosis obliterans from February 2016 to February 2018 in Central Hospital of Yuncheng City, Shanxi Province were chosen. The patients were divided into control group (35 patients) with POBA dilatation and observation group (35 patients) with POBA and DCB dilatation by random sampling method. The target vessel patency rate, target lesion revascularization rate, minimum lumen diameter and ankle brachial index (ABI) level before and after surgery, Rutherford classification in follow-up after surgery, late lumen loss after surgery and perioperative complications incidence of 2 groups were compared.Results:The target vessel patency rate 6 and 12 months after surgery in observation group was significantly higher than that in control group: 85.71% (30/35) vs. 62.86% (22/35) and 80.00% (28/35) vs. 48.57% (17/35), and there was statistical difference ( P<0.05). The target lesion revascularization rate in observation group was significantly lower than that in control group: 8.57% (3/35) vs. 28.57% (10/35), and there was statistical difference ( P<0.05). The minimum lumen diameter 6 and 12 months after surgery in observation group was significantly more than that in control group and before surgery: (3.20 ± 0.66) mm vs. (1.53 ± 0.38) and (0.45 ± 0.09) mm, (2.97 ± 0.60) mm vs. (1.40 ± 0.35) and (0.45 ± 0.09) mm, and there was statistical difference ( P<0.05). The ABI 6 and 12 months after surgery in observation group was significantly higher than that in control group and before surgery: 0.86 ± 0.17 vs. 0.63 ± 0.09 and 0.24 ± 0.06, 0.82 ± 0.14 vs. 0.60 ± 0.08 and 0.24 ± 0.06, and there was statistical difference ( P<0.05). The proportion of late lumen loss and Rutherford classification >3 12 months after surgery in observation group were significantly less than those in control group: (0.42 ± 0.10) mm vs. (1.59 ± 0.32) mm and 17.14% (6/35) vs. 57.14%(20/35), and there were statistical differences ( P<0.05). The perioperative complications incidence in observation group was significantly lower than that in control group ( P<0.05). Conclusions:Compared with POBA dilatation, DCB dilatation in the treatment of patients with lower extremity arteriosclerosis obliterans possesses better clinical efficacy and safety.

Sciatic nerve leachate of cattle causes neuronal differentiation of PC12 cells via ERK1/2 signaling pathway

Previous studies have shown that the sciatic nerve has neurotrophic activity, and nerve regeneration, differentiation, and axon outgrowth can be modulated by different sciatic nerve preparations. However, numerous animals may have to be sacrificed to obtain enough sciatic nerves to make a sciatic nerve preparation. Some studies have demonstrated that the role of sciatic nerve preparations in neural differentiation depends on the neurotrophins that Schwann cells secrete, and these factors are highly conserved among different species. To reduce the use of experimental animals, in this study, we made a leachate by using the sciatic nerve of cattle and explored its effect on neuronal differentiation of rat PC12 cells (a useful model for studying neuronal differentiation). Results showed the neurite outgrowth of PC12 cells treated with the cattle sciatic nerve leachate for 3, 6, and 9 days was significantly improved, and the expressions of β3-tubulin and microtubule-associated protein 2 (two neuron-specific proteins) were increased. Moreover, the ERK1/2 signaling pathway was activated after PC12 cells were incubated with cattle sciatic nerve leachate for 9 days. Thus, a sciatic nerve leachate obtained from cattle can effectively induce neuronal differentiation of rat PC12 cells via ERK1/2 signaling pathway.

Shear wave elastography guided biopsy in diagnosis of tuberculous peritonitis / 中国介入影像与治疗学

Objective To assess the clinical value of ultrasound shear wave elastography (SWE) guided biopsy for diagnosis of tuberculous peritonitis.Methods Clinical data of 25 tuberculous peritonitis patients who underwent SWE guided biopsy (SWE guided group) and other 25 tuberculous peritonitis patients who underwent conventional ultrasound guided biopsy (conventional ultrasound guided group) were retrospectively analyzed.The successful rate of biopsy and the complication occurrence were compared between the two groups.Results The success rate of SWE guided group was 100％(25/25),and the rate of complication occurrence was 8.00％ (2/25).The successful rate and complication occurrence in conventional ultrasound guided group was 84.00％ (21/25) and 32.00％ (8/25),respectively.There were statistical differences of success rate of biopsy (x2=4.348,P=0.037) and the complication occurrence (x2=4.500,P=0.034) between the two groups.Conclusion Compared with conventional ultrasound,SWE guidance can improve the success rate and reduce the complication occurrence of biopsy.

Clinical value of CEUS guided biopsy in diagnosis of lymphoma in anterior mediastinum / 中国介入影像与治疗学

Objective To explore the clinical value of CEUS guided biopsy of lymphoma in anterior mediastinum.Methods The data of 36 patients with lymphoma of anterior mediastinum underwent biopsy guided by CEUS and 36 patients by conventional ultrasound retrospectively.The successful rate of biopsy and rate of complication occurence were compared between the CEUS group and conventional ultrasound group.Results The successful rate of biopsy in CEUS group was 100％ (36/36),including 26 non-Hodgkin's lymphoma (NHL),10 Hodgkin's lymphoma (HL).The total times of puncture were 60 in 36 patients.The rate of complication occurrence was 11.11 ％ (4/36).The successful rate in conventional ultrasound group was 88.89％ (32/36),including 22 NHL,14 HL.The times of puncture were 91 in 36 patients.The rate of complication occurrence was 41.67％ (15/36).There were significant differences in successful rate and the rate of complication occurrence between two groups (x2 =4.235,8.651,P=0.040,0.003).Conclusion CEUS can reflect the microcirculation of lymphomas in anterior mediastinum,and can guide targeted biopsy.It can improve the successful rate of biopsy and reduce the complications.

Rapid diagnosis of venous catheterization complications: an ultrasound imaging study / 中国医师杂志

Objective To explore the value of ultrasound imaging in complications associated with venous catheterization.Methods Patients (n =853) underwent ultrasound imaging examination after venous catheterization.Ultrasonography manifestations of venous catheterization complications and clinical curative effect were analyzed and summarized.Results Phlebitis,thrombus and mechanical complications were found by ultrasound imaging examination.Pneumothorax,hemothorax,arterial puncture and hematoma were among the main mechanical complications.Among the 853 patients,85 cases (9.96％) were found to have complications by ultrasound examination,with 35 cases (4.10％) of phlebitis,26 cases (3.05％) of catheter-related thrombus and 24 cases (2.81％) of mechanical complications.Conclusions In summary,a variety of venous catheterization complications can be diagnosed using ultrasound imaging non-invasively,effectively and efficiently.Real-time ultrasound imaging examination can dynamically monitor the develop ment and evolution of venous catheterization complications and effectively evaluate outcomes.

Relations between timing of treatment in stanford B acute aortic dissection vascular repair and prognosis / 中国基层医药

Objective To investigate clinical relevance of the acute Stanford B aortic dissection vascular repair time for treatment and prognosis.Methods A retrospective clinical data of our hospital treated 1 10 cases of vascular repair of acute aortic dissection type Stanford B were analyzed according to the onset to treatment time.They were divided into three groups:group A (onset to treatment time of 7 days),group B (onset to treatment time 14) and group C (onset to treatment time than 14 days);the three groups were observed after aortic repair status and prognosis related indicators.Results The true lumen false lumen diameter and maximum diameter ratio in group A was the largest (1.8 ±0.5),which was significantly higher than that of group B and group C (1.3 ±0.3)and (1.3 ± 0.2),the difference was statistically significant (F=7.352,P<0.05).Ratio of preoperative minimum true lumen diameter and the maximum diameter of the false lumen,ratio of postoperative maximum true lumen diameter and the maximum diameter of the false lumen were associated with the onset of the endovascular repair time,showed a negative correlation (r=-0.452,-0.281,all P<0.05).postoperative complication rate of group A was 12.8%,complica-tion rate of group B was 29.5%,complication rate of group C was 33.3%,data of group A was significantly lower than those of group B and group C,the difference were statistically significant (χ2 =4.024,4.721,all P<0.05).group A died three cases,group B had 1 patient died and in group C there was no deaths.Hospital stay and hospital costs of group A were significantly lower than those of group B and group C,the difference werestatistically significant (F=4.125,7.375,all P<0.05).Conclusion As soon as possible to implement acute aortic dissection stanford B aortic vascular repair could better improve outcomes,and reduce the cost of hospitalization and treatment.At the same time, it can reduce the incidence of complications and improve clinical safety.

Design of the multi-functional bone forceps characterized by gripping, bending and cutting / 生物医学工程学杂志

We have designed a sort of multi-functional bone forceps for use as orthopedic surgical instruments to grip, bend and cut the spicula. It is labor-saving and easily installed. Its left and right clamp bodies are connected by a rivet to hold the spicula, and the pressure-regulating shank is connected with the clamp seat body at the right top of the clamp body by a rivet. It is used to curve the spicula. At an appropriate location on the pressure-regulating shank is a pin-cutting chip. On the right body rotating disc-clamp, there is a rectangular open cutting groove to be in use for cutting the specula with the role of pin-cutting chip. Being characterized by the use of mechanical leverage, the manipulations of holding and bending are less arduous. After achieving the 90-degree bend, the operator can cut off the specula successfully. The operation is easy to perform and labor-saving; the forceps can further meet the actual clinical demand.