Helix hydro-jet compared with the holmium laser lithotripsy in the treatment of intrahepatic bile duct stones / 中华普通外科杂志

Objective To evaluate the curative effect,safety,advantages and disadvantages of helix hydro-jet and holmium laser lithotripsy in the treatment of intrahepatic bile duct stones.Methods 158 patients of intrahepatic bile duct stones were divided into helix hydro-jet group (n =82) and helix hydro-jet group (n =76).Time of lithotripsy,frequencies of lithotripsy,residual stone,intraoperative hemorrhage,postoperative hemorrhage,stone recurrence rate,postoperative fever,and therapeutic efficacy were compared between the two groups.Results There was no significant difference between the two groups on frequency of lithotripsy,residual stone rate and stone recurrence rate (P ＞ 0.05) ; whereas intraoperative washing normal saline (2 300 ± 275) ml vs (2 850 ± 331) ml,(P =0.002),the time of lithotripsy (54.2 ± 15.3) min vs (38.1 ± 12.7) min,P =0.041,intraoperative hemorrhage (19 cases vs 29 cases,P =0.041),Intraoperative analgesia (2 cases vs 9 cases,P =0.032),postoperative hemorrhage (11 cases vs 21 cases,P =0.037),and postoperative fever (30 cases vs 62 cases,P =0.027) had significant differences(P ＜ 0.05).Conclusions Both helix hydro-jet and the holmium laser lithotripsy is safe and effective for the treatment of intrahepatic bile duct stones.Holmium laser is more efficient than Helix Hydro-jet,while helix hydro-jet is safer than holmium laser in lithotripsy.

BOLD-fMRI Study of Auditory Cortex in Patients with Sensorineural Hearing Loss / 听力学及言语疾病杂志

Objective BOLD-fMRI was used to observe the activated auditory cortex evoked by pure tone stimuli in patients with sensorineural hearing loss and this paper is to discuss the objective measure for patient with sensorineural hearing toss. Methods BOLD-fMRI examinations were taken in 22 patients with unilateral moderate to severe sensorneural hearing loss and 15 control subjects. The volumes and intensities of the two hemispheres of the activated auditory cortex were analyzed quantitatively. Results Significant activation was found in the temporal lobe in control subjects, and significant differences in the volume and intensity were noted between the contralateral and ipsilateral activated auditory cortexes in them (P<0.01), exhibiting clearly eontralateral predominance. When the normal ear of patients with sensorineural hearing loss received signals, there was no significant difference be-tween contralateral and ipsilateral activated auditory cortexes (P>0.05). Conclusion When the normal ear of pa-tients with sensorneural hearing loss was stimulated by pure tone, the contralateral hemisphere predominance disap-peared. This result seems to show the plasticity of auditory cortex of patients with unilateral hearing loss.

The rehabilitating effect of hyperbaric oxygen on visual pathway lesions / 中华物理医学与康复杂志

Objective To evaluate the rehabilitating effect of hyperbaric oxygen on visual pathway lesions with blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) and diffusion tensor imaging (DTI). Methods Sixteen patients with visual pathway lesions (the study group) and twelve healthy volunteers (the control group) were assessed using BOLD-fMRI and DTI. After hyperbaric oxygen therapy, the patients in the study group were again assessed using BOLD-fMRI and DTI. The activated regions of the BOLD-fMRI scan and the fractional anisotropy (FA) value determined from the DTI were calculated. Results Before hyperbaric oxygen treatment, there were significant differences between control and study groups in their BOLD-fMRI activated regions and the FA values of their radiation optics (P≤0.01). After hyperbaric oxygen treatment, there were no significant differences. Conclusion Combining BOLD-fMRI with DT1 could be used to evaluate the rehabilitation effect of hy-perbaric oxygen treatment in patients with visual pathway lesions.

Air plethysmography in diagnosing deep venous valvular insufficiency of lower limbs / 中国普通外科杂志

Objective To study the diagnostic value of air plethysmography (APG) in deep venous valvular incompetence of lower limbs and the relationship between deep venous reflux and calf muscular pump function. Methods Sixty-five varicose cases (89 limbs) were detected by APG in alterations of venous filling index (VFI), ejection fraction(EF), residual volume fraction(RVF) and outflow fraction(OF). Of 89 limbs, 18 limbs were in GradeⅠ of deep venous reflux, 24 in Grade Ⅱ, 18 in Grade Ⅲ and 12 in Grade Ⅳ. Integrated vectors analysis (Hotelling T 2test) was done with these index. Venography was performed in all patients. Results There were statistical differences in VFI between each two Grades of deep venous reflux except for between Grade Ⅰ and Ⅱ. There were also statistical differences in EF,RVF and OF between Grade Ⅳ and the other Grades. Hotelling T 2test showed significant testing efficiency of APG. ConclusionsDeep venous valvular insufficiency of lower limbs can be assessed by APG. VFI is a reliable quantitative index for evaluating the degree of deep venous reflux. There may be an exponent relation between deep venous reflux and calf muscular pump function.

CT,MRI and pathological analysis of peripheral primitive neuroectodermal tumors / 中华放射学杂志

Objective To analyze the CT and MRI appearances and to improve the knowledge of peripheral primitive neuroectodermal tumors(pPNETs).Methods CT or MRI were performed in 19 patients of pPNETs,which were confirmed by pathology.Results All the tumors were with unclear margin.Three cases occurred in intracalvarium,7 in the extremities,2 in the chest,4 in the abdomen,and 3 inside the spine.CT appearance of the tumors arising from soft tissue showed large,ill-defined,non-calcified mass and heterogeneous appearance with hypodense cystic areas.The tumors demonstrated heterogeneous contrast enhancement.The pPNETs arising from bone demonstrated extensive lytic lesion with large soft tissue mass,one case with newly-born bone and demonstrated heterogeneous contrast enhancement.The tumors demonstrated homogeneous intensity as muscle on SE T1WI and heterogeneous hyperintense signal on T2WI.Immunohistochemically,tumor cells showed positive for CD99,Syn,GFAP and negative for LCA.Conclusion The pPNETs show no characteristic manifestations on CT and MRI.However,CT and MRI can show the intra-tumor structures and the extent of the tumor very well,which is helpful in differentiating diagnosis,predicting resectability,detecting distant metastases and evaluating the response to treatment.