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[Objective]To investigate the diagnostic value of quantitative perfusion parameters of dynamic contrast-enhanced im?aging for discriminating metastatic from non-metastatic regional lymph nodes in rectal cancer.[Methods]122 patients of our depart?ment were collected from 2015.01 to 2016.08, and 203 lymph nodes, including metastatic lymph nodes (MLNs, n=95) and non-meta?static lymph nodes (NMLNs, n=108), were analyzed. The short-axis diameter (S), long-axis diameter (L), short-to long-axis diameter ratio (S/L), volume transfer constant (Ktrans), rate constant (Kep) and extravascular extracellular space (EES) fractional volume (Ve) were compared between two groups respectively. Then using S=5 mm as a cutoff value, these parameters were compared between subgroups. Receive operating characteristic curve (ROC) was used to analyze the diagnostic efficiency and find the optimal cutoff values.[Re?sults]The metastatic group exhibited higher S and L, but lower S/L, Ktrans and Kep than the non-metastatic group (P<0.01). However, the Ve did not differ significantly between two groups (P=0.308). Optimal cutoff values [area under the curve (AUC), sensitivity, speci?ficity] of Ktrans for discriminate metastatic lymph nodes from non-metastatic were 0.088 min-1 (0.69, 58.3%, 78.9%). When S>/=5 mm, subgroup analysis revealed that Ktrans and Kep of MLNs were significant higher than those of NMLNs (P<0.001), but Ve was lower (P=0.039). Optimal cutoff values (AUC, sensitivity, specificity) of Ktrans were 0.088 min-1 (0.675, 57.1%, 77.9%). However, when S<5 mm, MLNs showed lower Ktrans than NMLNs (P=0.001), but there were no significantly statistic differences of Kep and Ve between these two groups (P>0.1). Optimal cutoff values (AUC, sensitivity, specificity) of Ktrans were 0.087 min-1 (0.732, 60.5%, 81.5%).[Conclusion]Ktrans can be used to discriminate regional MLNs from NMLNs in rectal cancer, especially when the short-axis diameter is less than 5 millimeters.
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BACKGROUND: iRegene collagen sponge exhibits stable physical and chemical properties, and has passed the test by the State Food and Drug Administration of China. OBJECTIVE: To study the hemostatic effect and the biocompatibility of the iRegene collagen sponge on a liver wound by means of rat models. METHODS: Liver trauma bleeding models were made in 21 Sprague-Dawley rats. These model rats were randomized into three groups (n=7 per group): experimental group with implantation and external application of iRegene collagen sponge; positive control group with implantation of medical collagen sponge and external application of iRegene collagen sponge; blank control group with external application of medical gauze. The bleeding time and amount on the liver wounds were observed. Histological observation on the liver wound was performed at 7, 14, 28 days after intervention. RESULTS AND CONCLUSION: The bleeding time was shorter in the experimental group than the positive control group (P ≤ 0.05). Beyond that, there was no difference in the bleeding amount and time among the three groups. Histological findings on the liver wound showed that the iRegene collagen sponge in the experimental group was completely wrapped with fibrous connective tissues and began to degrade at 7 days after intervention, the Inflammatory cell infiltration mainly occurred in neutrophils, and new capillaries were observed in peripheral connective tissues; at 14 days after intervention, the fibrous connective tissues became remarkably thickened, the number of neurophils was reduced, and the number of macrophages was increased; at 28 days after intervention, the iRegene collagen sponge degraded completely, most of the liver tissues recovered, and there were macrophages, monocytes, fibroblasts and capillaries in the inflammatory connective tissues adjacent to a part of liver tissues. Similar findings were observed in the positive control group. In the blank control group, there were obvious connective tissues on the wound and red blood cells in the liver sinus, and occasionally liver tissue bleeding and vacuolar degeneration were visible; at 28 days after intervention, there were thickened connective tissues on the wound, red blood cells in the liver sinus and reversed hepatic stellate cells. To conclude, the iRegene collagen sponge possesses effective hemostatic effects on liver wounds and shows good histocompatibility.
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BACKGROUND: iRegene collagen sponge exhibits stable physical and chemical properties, and has passed the test by the State Food and Drug Administration of China. OBJECTIVE: To study the hemostatic effect and the biocompatibility of the iRegene collagen sponge on a liver wound by means of rat models. METHODS: Liver trauma bleeding models were made in 21 Sprague-Dawley rats. These model rats were randomized into three groups (n=7 per group): experimental group with implantation and external application of iRegene collagen sponge; positive control group with implantation of medical collagen sponge and external application of iRegene collagen sponge; blank control group with external application of medical gauze. The bleeding time and amount on the liver wounds were observed. Histological observation on the liver wound was performed at 7, 14, 28 days after intervention. RESULTS AND CONCLUSION: The bleeding time was shorter in the experimental group than the positive control group (P ≤ 0.05). Beyond that, there was no difference in the bleeding amount and time among the three groups. Histological findings on the liver wound showed that the iRegene collagen sponge in the experimental group was completely wrapped with fibrous connective tissues and began to degrade at 7 days after intervention, the Inflammatory cell infiltration mainly occurred in neutrophils, and new capillaries were observed in peripheral connective tissues; at 14 days after intervention, the fibrous connective tissues became remarkably thickened, the number of neurophils was reduced, and the number of macrophages was increased; at 28 days after intervention, the iRegene collagen sponge degraded completely, most of the liver tissues recovered, and there were macrophages, monocytes, fibroblasts and capillaries in the inflammatory connective tissues adjacent to a part of liver tissues. Similar findings were observed in the positive control group. In the blank control group, there were obvious connective tissues on the wound and red blood cells in the liver sinus, and occasionally liver tissue bleeding and vacuolar degeneration were visible; at 28 days after intervention, there were thickened connective tissues on the wound, red blood cells in the liver sinus and reversed hepatic stellate cells. To conclude, the iRegene collagen sponge possesses effective hemostatic effects on liver wounds and shows good histocompatibility.
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Objective:TTo evaluate the nutritional status,immune function and clinical effectiveness of early enteral immunonutrition in patients receiving totally endoscopic esophagectomy.Methods:There were 90 patients receiving totally endoscopic esophagectomy enrolled in Department of Thoracic Surgery of The Fourth Hospital of Hebei Medical University between May 2015 and October 2016.The patients were randomly divided into three groups,enteral immunonutrition group (EIN group,n =30),common enteral nutrition group(EN group,n =30)and parenteral nutrition group (PN group,n =30).The levels of nutritional indexes,immune indexes,C-reactive protein (CRP) were measured preoperation and 1day,3days,7days after surgery.We also observed the first postoperative anal exhaust time,infectious complications and the length of hospital stay.Results:There were no significant differences in age,gender,tumor location,clinical stage,CRP,the nutritional indexes and immune indexes between the three groups before operation.On the first day after operation,the nutritional indexes and immune indexes of the three groups were significantly lower than those before operation,then all the indexes began to recover.Otherwise,CRP of the three groups were significantly higher than those before operation,then fell down in the following days,the rate of EIN group and EN group was faster than that of PN group on the day 3 after surgery and the EIN group was the fastest on the day 7 after surgery.There were significant differences in the first postoperative anal exhaust time,pneumonia and the length of hospital stay.And there was no significant difference in the incidence of anastomotic fistula between the three groups(x 2=1.071,P =0.585).Conclusions:Postoperative early enteral immunonutrition can improve the nutritional status and the immune response,promote the rapid recovery in the patients receiving totally endoscopic esophagectomy.
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Objective To study the value of plasma brain natriuretic peptide (BNP) levels on the cardiac function evaluation in children with left-right shunt congenital heart disease (CHD).Methods Thirtytwo children with left-right shunt CHD were selected and divided into right ventricular group (14 cases) and left ventricular group (18 cases) according to the heart load capacity types.Twenty healthy children were selected as control group.Then plasma BNP levels were determined by enzyme-linked immunosorbent assay method and the left ventricular ejection fraction (LVEF),left ventricular end-diastolic diameter (LVEDD),right ventricular end-diastolic diameter (RVEDD),pulmonary blood flow (Qp)/systemic blood flow ratio(Qs) and left heart Tei index were determined by echocardiography and compared.Results The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index were (60.21 ± 26.78) rng/L,(35.71 ± 6.98) mm,(25.04 ± 5.52) mm,1.74 ± 0.24,0.34 ± 0.12 in right ventricular group.The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index were (64.57 ± 25.18) ng/L,(45.27 ± 7.26) mm,(12.34 ± 2.18) mm,1.78 ± 0.19,0.36 ± 0.11 in left ventricular group.The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index were (33.42 ± 9.46) ng/L,(32.31 ± 4.87) mm,(10.98 ± 1.60) mm,0.92 ± 0.11,0.28 ± 0.08 in control group.The plasma BNP levels,LVEDD,RVEDD,Qp/Qs and left heart Tei index in right ventricular group and left ventricular group were higher than those in control group,and there were significant differences (P ＜ 0.05).There was no significant difference in LVEF among three groups (P ＞ 0.05).The plasma BNP levels in right ventricular group had positive correlation with RVEDD (r =0.634,P ＜ 0.05),Qp/Qs (r =0.721,P ＜ 0.05) and left heart Tei index (r =0.647,P ＜ 0.05).The plasma BNP levels in left ventricular group had postive correlation with LVEDD (r =0.547,P ＜ 0.05),Qp/Qs(r =0.794,P ＜ 0.05) and left heart Tei index (r =0.745,P ＜ 0.05).There was no correlation between the plasma BNP levels and LVEF in right ventricular group and left ventricular group.Conclusion The plasma BNP levels determination helps the early cardiac function evaluation of left-right shunt CHD,and combined with echocardiography can accurately reflect the early cardiac function of the left-right shunt CHD,which can provide objective basis for the clinical diagnosis and treatment.
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Objective To explore the effect of atorvastatin on high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in unstable angina pectoris (UAP) patients after intervention.Methods Eighty cases with UAP who underwent percutaneous coronary intervention (PCI) were divided into group A and group B by random digits table method with 40 cases each after PCI.The patients in group A were given regular heart treatment and atorvastatin 20 mg treatment.The patients in group B were given regular heart treatment and atorvastatin 40 mg treatment.The serum hs-CRP and IL-6 was determined before treatment and 24 h,3 weeks after treatment and compared between two groups.Results There was no significant difference in the serum hs-CRP and IL-6 before treatment between group A and group B [(5.6 ± 1.2) mg/L vs.(5.6 ± 1.1) mg/L and (211.9 ± 21.2) ng/L vs.(209.6 ± 19.9) ng/L,P ＞ 0.05].The serum hs-CRP and IL-6 24 h after treatment in group A and group B were increased compared with that before treatment,and there was significant difference(P ＜ 0.05),but there was no significant difference between group A and group B[(8.1 ± 1.1) mg/L vs.(8.5 ± 1.2) mg/L and (311.1 ± 20.9) ng/L vs.(313.3 ± 18.5) ng/L,P＞ 0.05].The serum hs-CRP and IL-6 3 weeks after treatment in group A and group B were decreased compared with that before treatment,there were significant difference (P ＜ 0.05),and there were significant difference between group A and group B [(3.1 ± 1.1) mg/L vs.(1.9 ±0.8) mg/L and (163.3± 18.5) ng/L vs.(123.3± 19.5)ng/L,P ＜ 0.05].No obvious adverse reaction was observed in two groups after treatment and liver function was not seen obvious anomaly.Conclusions Atorvastatin treatment in UAP patients after PCI can significantly reduce the serum hs-CRP and IL-6,and the 40 mg treatment is better than the 20 mg treatment.It is worth of clinical application.