Clinical analysis of ultrasound-guided catheterization in intraperitoneal perfusion chemotherapy for postoperative abdominal malignant tumor without ascites / 肿瘤研究与临床

Objective To investigate the clinical value of ultrasound-guided catheterization in intraperitoneal perfusion chemotherapy for postoperative abdominal malignant tumor without ascites. Methods A retrospective analysis were performed in 146 postoperative patients with abdominal malignancies who were admitted to Fujian Cancer Hospital from April 2013 to September 2018, and there were no ascites founded in these patients before abdominal catheterization. Two hundred and seventy-nine times ultrasound-guided catheterization in intraperitoneal perfusion chemotherapy were performed under clinical guidance. Results Two hundred and seventy-seven times abdominal catheterization was completed, with a success rate of 99.3％(277/279), and the one-time success rate was 83.2％(232/279), 2 times (0.7％, 2/279) had to be abandoned for peritoneal adhesions. Fifty-three patients (36.3％, 53/146) underwent catheterization ≥ 2 times. The intraperitoneal perfusion chemotherapy was successfully completed after catheterization, no intestinal injury and bleeding occurred. Conclusions In the absence of ascites, ultrasound guided catheterization in perfusion chemotherapy is safe, reliable, simple, accurate and has a high success rate. This new approach is good for clinical application when the conventional catheterization with ascites is blocked.

Efficacy of superficial temporal artery pressure-guided selective cerebral perfusion during deep hypothermic circulatory arrest in patients undergoing aortic arch surgery / 中华麻醉学杂志

Objective To evaluate the efficacy of superficial temporal artery(STA)pressure-guided selective cerebral perfusion(SCP)during deep hypothermic circulatory arrest(DHCA)in patients undergoing aortic arch surgery.Methods Ninety-six patients of both sexes,aged 35-64 yr,with body mass index of 19-23kg/m2,of American Society of Anesthesiologists physical status Ⅲ or Ⅳ,undergoing aortic arch surgery,were divided into STA pressure group(group A)and clinical experience group(group B)using a random number table,with 48 patients in each group.In group A,STA catheterization was performed after tracheal intubation,and arterial pressure was monitored.SCP flow was adjusted to maintain the target value of STA pressure between 30 and 40mmHg during DHCA in group A.SCP flow rate was set at 5-10ml·kg-1·min-1 according to clinical experience in group B.The volume of fluid perfused during SCP,emergence time,extubation time and duration of intensive care unit stay were recorded.Neurological function was evaluated during length of hospitalization after surgery,and the development of permanent and transient neurological dysfunction and mortality in hospital were recorded.Results Compared with group B,the volume of fluid perfused during SCP was significantly decreased,the emergence time,extubation time and duration of intensive care unit stay were shortened,the incidence of permanent and transient neurological dysfunction(2% and 4%,respectively)was decreased(P 0.05).Conclusion Maintaining STA pressure at 30-40mmHg is a reliable method for guiding SCP during DHCA in patients undergoing aortic arch surgery.

Monte Carlo simulation methods of determining red bone marrow dose from external radiation / 中华放射医学与防护杂志

Objective To provide evidence for a more reasonable method of determining red bone marrow dose by analyzing and comparing existing simulation methods.Methods By utilizing Monte Carlo simulation software MCNPX,the absorbed doses of red hone marrow of Rensselaer Polytechnic Institute (RPI)adult female voxel phantom were calculated throush 4 different methods:direct energy deposition.dose response function(DRF),King-Spiers factor method and mass-energy absorption coefficient (MEAC).The radiation sources were defined as infinite plate.sources with the energy ranging from 20 keV to 10 MeV.and 23 sources with different energies were simulated in total.The source was placed right next to the front of the RPI model to achieve a homogeneous anteroposterior radiation scenario.The results of different simulated photon energy sources through different methods were compared.Results When the photon energy was lower than 100 key,the direct energy deposition method gave the highest result while the MEAC and King-Spiers factor methods showed more reasonable results.When the photon energy was higher than 150 keV taking into account of the higher absorption ability of red bone marrow at highcr photon energy,the result of the King-Spiers factor method was larger than those of other methods.Conclusions The King-Spiers factor method might be the most reasonable method to estimate the red bone marrow dose from external radiation.

Impact of tomotherapy beam block on the room shielding thickness / 中华放射医学与防护杂志

Objective To study the calculation of the room shielding thickness of tomotherapy accelerator,a new type of radiotherapy facility,especially the impact of the beam block on the shielding design.Methods According to the relevant standards,combined with the room geometry,the shielding thickness was calculated without the presence of the beam block,considering the primary beam,the scattered beam and leakage.Meanwhile,the shielding thickness was also calculated as comparison with the presence of the beam block,based on the characteristics of tomotherapy facility and its radiation field.Results There was statistical difference between the shielding thicknesses calculated with the presence of the beam block and those without the beam block,to the primary beam direction including the south wall,north wall,the roof and the floor,the shielding thickness were decreased by 95.59%,63.63% ,80.73%and 51.30% ,respectively.Conclusions For the tomotherapy accelerator,the beam block could be of great help to minify the shielding thickness of the room.The radiation field of the tomotherapy facility could be used for the calculation to improve accuracy,and the shielding thickness can also be estimated by subtracting the initial shielding thickness without beam block of the beam block equivalent thickness in the primary beam direction alternatively.

Influence of aoustic contrast agent with diagnostic ultrasound on rabbits' spermatogenic cell / 中华超声影像学杂志

Objective To study the impact of ultrasound contrast agent with different doses or imaging modes on rabbit spermatogenic cell in the diagnosis of radiation dose.Methods Thirty-three New Zealand white rabbits were randomly divided into 3 groups.In group Ⅰ ,three minutes gray scale ultrasound radiation was performed for three rabbits.In group Ⅱ, SonoVue was bolus injected from ear vein for eighteen rabbits.The rabbits in this group were divided into 6 sub-group according to different doses and different sampling times, the single injections of SonoVue with dosage of 0.1 ml/kg(A1, A2) or 1 ml/kg (C1 ,C2) and repeated injections with dosage of 0.1 ml/kg interval 15 min (B1 ,B2) were taken.In group Ⅲ ,twelve rabbits were bolus injected with SonoVue and then the agent bubbles were blasted when the SonoVue suffused the whole testis.The rabbits in this group were divided into 4 sub-groups according to different doses and different sampling times, and the dosages of SonoVue were 0.1 ml/kg(D1, D2) and 1 ml/kg(E1,E2).Testis were drew immediately or 24 hours later for the observation under light microscope and transmission electron microscope.Results Apoptotic cells in group Ⅲ were more than those in group Ⅰ and Ⅱ ( P ＜0.05) ,while no significant difference of the total number of apoptotic cells between group Ⅰ and Ⅱ ( P ＞0.05).The appearances of focal ultra-structural damage were observed by transmission electron microscope in group C1, such as intercellular space widening and mitochondria swelling, and no distinct damage were observed in the other groups.The appearances of intercellular space widening, mitochondria swelling and cellular edema were observed by transmission electron microscope in group Ⅲ, and spotty necrosisetc was also observed in group D1 and E1.Conclusions Large dose of contrast agent could cause germ cells slight instantaneous effects, while conventional dose had no effect.Contrast agent blasting may cause germ cells unrecoverable damage.

Anesthesia of Children with Grave Congenital Heart Diseas es during Cardiac Catheterization and Ventriculography——369 Cases Review / 中国循环杂志

Objective:To introduce our experience on extra-operating room anesthesia of children with grave congenital heart diseases during cardiac catheterization an d ventriculography. 　　Methods:Three hundred and sixty-nine children with grave congenital heart d iseases undergoing cardiac catheterization or ventriculography were selected for this study,among whom 86 are presented with left to right shunt and pulmonary a rtery hypertention,11 with pulmonic stenosis and primary pulmonary artery hypert ention,and 272 with right to left shunt.They were routinely fasted before the pr ocedure.O2 Saturation(SpO2) and electrocardiogram were monitored and blood p ressure were recorded.With oxygen inhalated by mask and venous route established ,the children were injected with scolapamine (0.02 mg/kg) and ketamine (1-2 mg /kg) for anesthesia induction.When patients lost conciousness,ketamine (6-8 mg/ kg) and droperidol (0.15-0.30 mg/kg) were given intromascularly for maintaine nce.During the procedure,ketamine (1-2 mg/kg) were given to deepen anethesia. 　　Results:The procedures were fufiled steadily.Eighteen patients presented wit h different kinds of complications such as abdomen distention,vomitting,arrhymia and refractory anoxia to defferent degrees.One patient died,and the mortality w as 0.27%. 　　Conclusions:Anesthesia of children with grave heart diseases during cardiac catheterization and ventriculography is particular.It is important for the anest hesiologists to be familiar with the pathophysiology of heart diseases,and suppl y sufficiant oxygen,keep airway open and unobstructed,avoid stomach regurgitatio n and inhalation and maintain sufficient sedation during the procedure.Oxygen sh ould be given continuously and SpO2 monitored posoperatively to avoid any comp lication.

Evaluation of the effect of acute normovolemic hemodilution on blood conservation during cardiovascular surgery / 中华麻醉学杂志

30% after ANH) and blood volume was maintained with crystalloid and colloid (1 : 3) . The preoperatively collected blood and the blood salvaged during operation were infused back to the patient after CPB. The operations were performed under CPB with moderate hypothermia. In patients undergoing atrial or ventricular septal defect tranexamic acid 20 ml-kg-1 was given and in other patients aprotinin 5 000 000 U was given. Hb, Hct and platelet count (PLT) were measured and recorded before operation, after ANH and 24h after operation. The volume of RBC salvaged during operation, CPB time and the volume of chest tube drainage at 24h after operation, the volume of whole blood, plasma, packed RBC, cryoprecipitate and platelet transfused and hospitalization time were also recorded. Results The demographic data were comparable between the two groups. There was no significant difference in CPB time and the total days of hospitalization between the two groups. The Hb at 24h after operation was significantly higher in group A +C [(122.2+18.8)g/L] than that in group C [(112.3+15.6)g/L] (P