Diagnostic value of contrast-enhanced ultrasound in judging the survival of graft after heteroautoplasty for secondary hyperparathyroidism.

BACKGROUND: Secondary hyperparathyroidism (SHPT) is one of the common complications of end-stage renal disease-uremia, and is mainly manifested as parathyroid hyperplasia and abnormal secretion of parathyroid hormone (PTH). OBJECTIVE: To investigate the value and advantages of contrast-enhanced ultrasound (CEUS) in evaluating the survival of autografts after parathyroidectomy + parathyroid autotransplantation. METHODS: In this study, 125 patients with renal failure due to polycystic kidney disease, chronic nephritis, diabetic nephropathy, lupus nephritis, and atherosclerotic nephropathy were enrolled as the participants and each of them had 4 secondary hyperactive parathyroid glands and underwent parathyroid autotransplantation. One parathyroid gland was taken from each patient and equally divided into 4 parts and placed in the subcutaneous fat of one forearm for transplantation. CEUS was performed 14 days after the transplantation to observe the micro blood supply of the graft and assess the survival and secretory function of the transplanted parathyroid. The grafts were divided into the partial survival group and the total survival group based on the enhancement characteristics. The survival of the grafts was determined by comparing the parathyroid hormone level in bilateral elbow cephalic veins 1 month after surgery. RESULTS: Among the 125 patients, 112 had linear or punctate enhancement of 2-4 parathyroid glands 14 days after surgery, and 13 patients had linear or punctate enhancement of 0-1 parathyroid gland. There were statistically significant differences in the perfusion pattern, enhancement uniformity, and parathyroid hormone levels in the cephalic veins at the elbow on both the graft and non-graft sides among all groups (P< 0.05). CONCLUSION: Compared to the detection of the difference in the parathyroid hormone level in the cephalic vein of bilateral elbows 1 month after surgery, CEUS can reflect the parathyroid survival after transplantation more quickly and accurately 2 weeks later, and provide a more rapid and agile non-invasive clinical diagnosis method.

Genetic Basis of Gastric Cancer / 中国医学科学杂志(英文版)

Gastric cancer is the result of multiple risk factors, including environmental factors, genetic factors and the interaction between them. The environmental factors mainly include dietary, Helicobacter pylori infection and family history of gastric cancer. Genetic factors mainly refer to the susceptible genes that cause epigenetic alterations in oncogenes, tumor suppress genes, cell cycle regulators, DNA repair genes and signaling molecules. This paper summarizes the susceptible genes of gastric cancer and explores the genetic basis of it.

Study of splenopancreatic-preserving dissection of No.10 and No.11 lymphatic nodes in radical resection for proximal gastric carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of splenopancreatic-preserving dissection of No.10 and No.11 lymph nodes in radical resection for proximal gastric carcinoma.</p><p><b>METHODS</b>The data of 62 patients with proximal gastric carcinoma undergoing splenopancreatic-preserving dissection of No.10 and No.11 lymph nodes were analyzed retrospectively.</p><p><b>RESULTS</b>This splenopancreatic-preserving dissection was effective significantly. The incidences of lymphatic metastasis in No.10 and No.11 were 19.4% and 22.6% respectively, and the incidence of complications was 16.1%, significantly lower than that (40 %) of non-splenopancreatic-preserving dissection.</p><p><b>CONCLUSIONS</b>The splenopancreatic-preserving dissection of No.10 and No.11 lymph nodes is a safe and feasible method in radical gastrectomy for proximal gastric carcinoma. The surgical procedure is not difficult. With careful operation,the complete clearance of the lymph nodes can be obtained.</p>

Diagnosis and treatment of penetrating anorectal wounds / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To research the diagnosis and effective treatment of penetrating anorectal wounds.</p><p><b>METHODS</b>Retrospective analysis was done in 16 cases of penetrating anorectal wounds from 1985 to 2004. Debridement and suture of anorectal and vesical wounds, effective diversion of fecal and urinary stream and sufficient presacral drainage were performed in all cases.</p><p><b>RESULTS</b>All the 16 cases were cured. Among them, 2 cases with infection in presacral space were cured by sufficient drainage after operation, one case was cured by secondary repair after anal sphincter was repaired unsuccessfully and one case with rectovesical fistula was cured with conservative treatment. None of them suffered from complications such as anal stenosis, dysuria or impotence etc.</p><p><b>CONCLUSIONS</b>For penetrating anorectal wound, to master early recognition of concomitant injures, to select appropriate surgical intervention and to strengthen perioperative treatment are the keys to improve the curative effects.</p>