Multi-section ultrasonic diagnosis and classification of congenital clubfoot / 中华超声影像学杂志

Objective:To evaluate and analyze the ultrasonic findings of idiopathic clubfoot and positional clubfoot deformities.Methods:Forty-nine newborn babies with congenital clubfoot were examined in the Department of Ultrasound of the Third Affiliated Hospital of Zhengzhou University from December 2020 to January 2022, Including 21 newborn babies(32 feet) with idiopathic clubfoot, and 28 babies(53 feet) with positional clubfoot. Twenty-two normal infants in the same period and the normal feet of the single clubfoot were selected as control group. The distance between medial malleolus and scaphoids of all feet were measured by ultrasound. The distance from the tangent line of the lateral edge of calcaneus to the midpoint of the lateral edge of the chondroid bone, medial soft tissue thickness and tibial calcaneal angle were measured by ultrasound. The data of idiopathic clubfoot group, positional clubfoot group and control group were statistically analyzed.Results:A total of 71 newborn babies with 142 feet were evaluated.The idiopathic clubfoot group had born and joint changes in the medial, lateral and posterior side, and the differences were statistically significant compared with the control group (all P<0.05). Compared with the control group, there were statistically significant differences in the medial and lateral side of the positional group(all P<0.05). But no significant changes in the posterior side( P>0.05). There were significant differences between medial and posterior side of idiopathic and positional clubfoot group (all P<0.05), but no significant differences in lateral side ( P>0.05). Conclusions:Ultrasonography can clearly display the tarsus bones in clubfoot, and observe the deformity changes of the idiopathic clubfoot and positional clubfoot.

A preliminary study on the ultrasonic evaluation of deformity changes during the treatment of congenital clubfoot in infants / 中华超声影像学杂志

Objective:To evaluate the deformity changes in the treatment of congenital clubfoot in infants by ultrasound, and to explore its clinical application value.Methods:Seventeen infants with congenital clubfoot treated in the Department of Pediatric Orthopaedics of the Third Affiliated Hospital of Zhengzhou University from March 2020 to June 2021 and 27 normal infants in the same period were selected. The distance between medial malleolus and scaphoids (MM-N distance) of all feet was measured by ultrasound. The distance from the tangent line of the lateral edge of calcaneus to the midpoint of the lateral edge of the chondroid bone (C-C distance), medial soft tissue thickness and tibial calcaneal angle were measured by ultrasound. The data before, after treatment and during follow-up were statistically analyzed.Results:A total of 88 feet of 44 infants were evaluated. The mean number of cast was 4.7±1.1, the follow-up time was (96.9±59.3)days. The MM-N distance, C-C distance and posterior tibial calcaneal angle in the clubfoot group were improved after treatment and at the last follow-up, and the differences were statistically significant (all P<0.01). During the treatment, 1 case had false correction, and 2 cases recurred in the last follow-up. Conclusions:Ultrasound can clearly display the medial, dorsal, lateral and posterior articular structures of normal and clubfoot, and can observe the deformity changes of clubfoot during the correction process, which can provide guidance for the clinical treatment of clubfoot.

A multicenter, randomized, open and positive parallel controlled clinical study of clotrimazole vaginal expansion suppository and vaginal tablet in the treatment of mild and moderate vulvovaginal candidiasis / 中华妇产科杂志

Objective:Using clotrimazole vaginal tablet as a positive control, to evaluate the results of clotrimazole vaginal expansion suppository in the treatment of mild and moderate vulvovaginal candidiasis in terms of efficacy, patient satisfaction, side effects, and recurrence rate.Methods:This study was jointly conducted by 5 hospitals from August 2017 to October 2018, patients with mild and moderate vulvovaginal candidiasis confirmed by fungal culture and symptoms scores were selected. They were randomized to experimental group and control group as 1∶1 ratio. In the experimental group ( n=105), the subjects applied clotrimazole vaginal expansion suppository (150 mg) daily at night for 7 days. In the control group ( n=106), the subjects used a single dose of clotrimazole vaginal tablet (500 mg). Follow-ups were performed at (8±3) and (30±5) days after the discontinuation of the drugs, respectively. The difference in clinical symptoms and signs scores was used to evaluate the improvement of clinical symptoms, and the patient′s satisfaction and side effects were recorded. Results:At the first follow-up, the experimental group and control group were followed up by fungal culture on the cure rate [66.7% (70/105) versus 63.2% (67/106), P>0.05] and total effective rate [98.1% (103/105) versus 99.1% (105/106), P>0.05], the differences were not statistically significant. At the second follow-up, the recurrence rates of the experimental group and the control group were 5.7% (4/70) and 14.9% (10/67), respectively, with no significant difference ( P>0.05). In the evaluation of patient satisfaction, the leakage of the drug in the experimental group was significantly better than that in the control group ( P<0.01). The side effects mainly included vaginal stimulation, itching and burning sensation, and there was no statistical difference between the two groups ( χ2=1.070, P=0.586). Conclusions:In the treatment of mild and moderate vulvovaginal candidiasis, clotrimazole vaginal expansion suppository is no less effective than clotrimazole vaginal tablet, and there is no significant difference in the recurrence rate between the two. In terms of patient satisfaction, clotrimazole vaginal expansion suppository is superior to clotrimazole vaginal tablet.

Delayed spontaneous rupture of cavernous segment of the internal carotid artery following dual ophthalmic segment aneurysms treatment with pipeline embolization device: A case report.

RATIONALE: The incidence of double aneurysms on the ophthalmic segment of the internal carotid artery (ICA) is very rare. Nevertheless, delayed rupture of a parent artery instead of the aneurysmal sac following pipeline embolization device (PLED) is unusual. PATIENT CONCERNS: We present a 72-year-old female who was admitted at our facility with gradual onset of nonspecific visual changes. DIAGNOSIS: Conventional angiography revealed 2 aneurysms located at the ophthalmic segment of the left ICA. INTERVENTIONS: Both aneurysms were successfully treated with PLED. OUTCOMES: Two months after discharge, the patient was rushed into the emergency with bilateral conjunctival congestion. Computed tomography revealed intracranial hemorrhage at left temporal lobe while digital subtraction angiography established a left direct carotid cavernous fistula. We utilized stent (Solitaire 6*30) assisted coils to occlude the fistula. The patient is well and go about her normal duties. LESSIONS: Manipulation of the tortuous parent artery resulted in a focal traumatic weakness in the artery and subsequently a delay tear. We are of the view that, endovascular surgeons should be on the lookout for this complication following flow deviation treatment modalities.

Concomitant occurrence of clinoid and cavernous segment aneurysms complicated with carotid cavernous fistula: A case report.

RATIONALE: Dual aneurysms arising from the internal cerotic artery (ICA) is a very rare occurrence. Clinoid segment aneurysms (CSAs) are often seen at the carotid dural rings while cavernous carotid aneurysms (CCAs) are often a direct communication between the ICA and the cavernous sinus (CS). We present a case of complex concomitant occurrence of a CSA and a CCA complicated with delay aneurysmal rupture (DAR) resulting in carotid cavernous fistula (CCF) after our initial treatment of the patient with pipeline embolization devices (PLEDs) PATIENT CONCERNS:: We present a 64-year old female who we admitted at our institution due to one-year history of double vision. Neurological examinations were unremarkable. DIAGNOSIS: Magnetic resonance imaging (MRI) and computer tomography (CT)-scan revealed dual aneurysms on the ICA. Digital subtracting angiogram (DSA) confirmed a small CSA and a large CCA on the right ICA. INTERVENTIONS: We treated both aneurysms with PLED and subsequently observed DAR of CCA as a complication. OUTCOMES: We successfully occluded the fistula with ONYX (ev3, Irvine, CA) via the trans-venous approach. LESIONS: PLED was the best endovascular treatment option though DAR was inevitable. Although the trans-arterial approach may be the gold standard for the managing of CCF, the complex nature of our case made us opt for trans-venous approach. The trans-venous route is very appropriate for fistulas with complex parent arteries.

Reactive in-stent stenosis of a pipeline embolization device in a child: A case report.

RATIONALE: Pipeline embolization device pipeline embolization device (PLED) is one of the most preferred flow-diverting devices used in treating giant and complex intercranial aneurysms. The occurrence of in-stent stenosis (ISS), which is a partially reversible complication, has been associated with PLED. Trauma around the neck of the aneurysm during our attempts to implant the PLED across the aneurysm resulted into inflammatory reactions, endotheliazation, granular tissue formation, and subsequent ISS. PATIENT CONCERNS: We present an 11-year-old girl with dizziness of 6 days duration on account of which she was admitted at our institution. Physical as well as neurological examinations did not yield much. DIAGNOSES: Cerebral angiography revealed a right cavernous segment giant aneurysm. INTERVENTIONS: We initially implanted Pipeline embolization devices (PLEDs) (ev3, Irvine, California, USA) across the neck of the aneurysm which resulted into ISS 6 months after the operation. OUTCOMES: We also attempted balloon angioplasty which failed during our second operation. She was finally treated with Neuroform stent (Stryker Neurovascular, USA) with no further complication and two years follow-up revealed no ISS. LESSONS SUBSECTIONS AS PER STYLE: A combination of multiple kinds of flow diverting devices could reduce the incidence of ISS in selected patients with complex aneurysms. Minimal trauma caused by PLED at aneurysm site could also reduce incidence of ISS.

Dural Arteriovenous Fistulas with Perimedullary Venous Drainage Successfully Managed Via Endovascular Electrocoagulation.

BACKGROUND: Dural arteriovenous fistulas (DAVFs) with perimedullary venous drainage are very rare intracranial DAVFs. Treating DAVF via an endovascular electrocoagulation technique, to the best of our knowledge, has not been reported in the literature. We therefore report the first successful case. CASE DESCRIPTION: We report a rare case of Cognard type V DAVF. The feeding arteries were the middle meningeal artery, the recurrent meningeal branch of ophthalmic artery, and the meningohypophyseal trunk. The patient presented with paresthesia and weakness in the lower limbs. T2-weighted magnetic resonance imaging revealed a high signal in the medulla oblongata and upper cervical spinal cord. Our first procedure via the middle meningeal artery with Onyx 18 (ev3 Neurovascular) as the embolization agent failed to occlude the fistula. We finally occluded the fistula with the endovascular electro-coagulation technique. Two-year follow-up revealed total disappearance of the fistula and relieve of patient's symptoms. CONCLUSIONS: The endovascular electrocoagulation technique is very effective in the management of complex DAVFs with perimedullary venous drainage.

Analyais of Distribution Characteristics and Drug Resistance of Pathogens in Dong’e County of Shandong Province from 2014 to 2015 / 中国药房

OBJECTIVE:To analyze the distribution characteristics and drug resistance of pathogens in Shandong Dong’e and to provide reference for local physicians to choose antimicrobial agents. METHODS:Detected pathogens in Dong’e coun-ty of Shandong province during Jan. 2014-Dec. 2015 were analyzed statistically in respects of type,distribution and drug re-sistance. RESULTS:A total of 25 562 specimens were collected from Dong’e county of Shandong province during 2014-2015,and there were 6 302 positive samples with positive rate of 24.65%. The samples with high positive rate included respiratory samples(positive rate of 34.52%)and secretion,pus(positive rate of 33.79%). A total of 6 350 pathogens were detected,among which there were 3 707 strains of Gram-positive bacterias (58.38%),mainly including Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia;2 042 strains of Gram-negative bacterias (32.16%),mainly including Staphylococcus aureus and Streptococcus pneumonia;601 strains of fungus. E. coli,S. aureus,P. aeruginosa,K. pneumonia, Acinetobacter baumannii and Proteus mirabilis mainly distributed in ICU,and S. pneumonia and Hemophilus influenza mainly distributed in pediatric department. Sensitive rates of E. coli and K. pneumonia to piperacillin sodium and tazobactam sodium, imipenem,amikacin and tigecycline were higher than 90%;the strain resistant to or intermediate to tigecycline was not found. Sensitive rate of P. aeruginosa to aminoside antimicrobial agents was higher than 90%. Resistant rates of A. baumannii to vari-ous antimicrobial agents were higher than 70%,and resistant rate of it to minocycline was 96.67%. S. aureus was sensitive to vancomycin,quinupristin/dalfopristin and tigecycline,and S. pneumonia was sensitive to rifarnpin,linezolid and vancomycin, with sensitive rate of 100%. A total of 264 strains of MRSA were detected,and detection rate was 39.28%;a total of 200 strains of penicillin-resistant S. pneumonia were detected,and detection rate was 35.13%. CONCLUSIONS:The samples from Dong’e county of Shandong province during 2014-2015 were mainly respiratory samples,detected pathogens were mainly Gram-negative bacterias and resistant rate of them were lower than related domestic reports. The distribution characteristics and drug resistance of pathogens should be considered before using antimicrobial agents to improve the rationality and perti-nence of drug use.

Congenital Pial Arteriovenous Fistula in the Temporal Region Draining into Cavernous Sinus: A Case Report

This report concerns a 4-month-old infant with progressive prominent and redness of his left eye since birth. This report concerns a 4-month-old infant with progressive prominent redness of his left eye since birth. Angiography revealed a congenital pial arteriovenous fistula between the temporal branch of the left posterior cerebral artery and left cavernous sinus through the sphenoparietal sinus, a condition not reported in the literature. The fistula was successfully occluded with two micro-coils by vertebrobasilar approach.

RE: Giant Cavernous Aneurysm Associated with a Persistent Trigeminal Artery and Persistent Otic Artery

No abstract available.

Application of endometrial sampling device during the follow-up visit for the conservative treatment of endometrial cancer / 中华妇产科杂志

Objective To study the feasibility of endometrial sampling device as a sampling tool during the follow-up visit for endometrial cancer patients undergone conservative treatment.Methods Before the hysteroscopy examination,endometrial sampling device was used to take the endometrium specimens 43times in 19 patients who had been diagnosed as endometrial cancer or atypical hyperplasia,and were undergone conservative treatment during May 2012 to Mar.2013.All cases accepted vaginal ultrasound screening before every sampling by endometrial sampling device.The histological results were compared with those done by hysteroscopy.Results The average age of those patients was (30 ± 6) years old.The mean thickness of the endometrium during the treatment was (0.81 ± 0.65) cm.The qualified rate for the sampling was 95％ (41/43).Compared with the specimens undergone by hysteroscopy direct sampling,32samples got by the endometrial sampling device with thicker endometrium (0.93 ± 0.70) cm had the same histological results,while the other 9 patients with thinner endometrium (0.40 ± 0.14) cm were not (P =0.031).Conclusion The endometrial sampling device could be used during the follow-up visit for the conservative treatment patients with endometrial cancer or atypical hyperplasia,the vaginal ultrasound screening should be used together to figure out those with thinner endometrium.

Experimental study on animal with automatic drug injection based on predictive control for vascular interventional therapy / 生物医学工程学杂志

This paper focuses on the animal experiment of automatic drug delivery based on predictive control for vascular interventional therapy. Improvement of drug delivery system based on predictive control used in simulated experiments was put forward after the presence of time varying parameters and the characteristics of individual differences of animal had been studied. The adaptability of time varying parameters and fault tolerance of the system were also enhanced. Different injection methods were tested on animals. It is proved that higher target blood concentration can be reached while injecting during diastolic than that while injecting during systolic or injecting at a constant speed within the whole cardiac cycle. The results also showed that the improved drug injection system based on predictive control which synchronizes with the cardiac cycle could be applied to clinical trials.

Establishment of virtual three-dimensional model for intravascular interventional devices and its clinical value / 中华放射学杂志

Objective To explore virtual three-dimensional (3D)model for intravascular interventional devices,the method of preoperative simulation and its value in clinical work.MethodsThe virtual models including catheter,guide wire,stent and coil were established by using the 3D moulding software of 3D Studio MAX R3. The interventional preoperative simulation was performed on personal computer including 21 patients of cerebral aneurysm embolization ( anterior communicating artery 5,posterior communicating artery 10,middle cerebral artery 3,internal carotid artery 2,and vertebral artery 1 ),during interventional procedures,the surgeon relied on the simulation results for plastic micro-guide wire,catheter and the release of micro-coils and stents.Results( 1 ) All the virtual instruments and real instruments had similar shape,the overall tine for constructing virtual model was about 20 hours.The preoperative simulation took 50 to 80 minutes. (2) The simulation result of catheter insertion in the 18 cases had relevant value to guide micro-catheter,molding micro-guide wire tip,and shortened the operating time.For embolization,the simulation results of filling coil and releasing stent were similar to surgical results in 76％ of the patients (16/21).(3)For teaching and training,93％ (38/41) of doctors in training believed that preoperative simulation facilitated the understanding of surgery. ConclusionsThe method of virtual model of intravascular interventional devices was reliable.The preoperative simulation results could be used to guide practical clinical operation with relatively high degree of similarity,and could play a role in promoting researches on interventional virtual operations.

A simulating excorporeal experimental system for automatic drug injection based on predictive control in vascular interventional therapy / 生物医学工程学杂志

This paper discusses an in vitro simulating experiment for drug injection based on predictive control in vascular interventional therapy. The relationship between the model of drug injection and the pulsatile blood flow was studied. The experimental model for predictive control of drug injection was tested and verified so as to support the future animal experimental modeling with the data acquired from the in vitro simulating experiment.

The advances of automatic drug infusion / 生物医学工程学杂志

The development of automatic drug delivery is reviewed in this paper. The control-relevance of models, the relevant algorithm, the system running and the simulation effect are introduced. The value for clinical application of each case is assessed. The new advances and high-lights of researches are discussed.

Embolization of a Bleeding Maxillary Arteriovenous Malformation via the Superficial Temporal Artery after External Carotid Artery Ligation

We report a new approach of embolization in a 15-year-old boy that presented with a massive hemorrhage from a maxillary arteriovenous malformation. Re-bleeding occurred after emergent ligation of the external carotid artery. The bleeding was successfully controlled by embolization via the superficial temporal artery.

Covered stents in neural interventional therapy / 中国组织工程研究

BACKGROUND: With the development of neural interventional therapy, the application of covered stents in neural intervention is becoming a topic of general interest.OBJECTIVE: To introduce the structure of stent-graft, and to summary the application of covered stents in clinical treatment of the neural interventional therapy and the shortage of covered stents.RETRIEVAL STRATEGY:The relevant articled were searched for in Pubmed database by researcher of this article with the key words of "stent graft, covered stents, cerebrovascular disease" in English, and with the key words of "covered stent, cerebrovascular disease" in Chinese in VIP database. 223 English and 196 Chinese articles were selected and reviewed primarily. Inclusive criteria: Articles having a close relation with the application of covered stents in neural intervention, especially in cerebrovascular disease, and the latest articles or articles published in authority journals in the same field were chosen. Exclusive criteria: articles with repetitive studies were excluded.LITERATURE EVALUATION: 223 English and 196 Chinese articles were primarily checked by reading titles and abstracts. Among the 31 collected articles, 4 are reviews, 3 are experimental studies and others are clinical studies.DATA SYNTHESIS: Covered stents show special advantages in neural interventional therapy and become a hot spot in present study. There are individual case reports or small group case reports on the application of covered stents in hemorrhagic cerebrovascular disease. It is reported that the covered stent effectively occludes aneurysm, dissecting aneurysm and arteriovenous fistula, keeps patency of the parent artery. The covered stent isolates ulcerated plaque via physical barriers, avoids the abscission of embolus, which can further reduce the development of embolism in percutaneous carotid artery stenting. After releasing covered stents, polytetrafluoroethylene makes the disepiment smooth. Its good biocompatibility reduces thrombosis, and then decreases the incidence of restenosis. Covered stents in vessel for cerebrovascular disease have achieved good effects, but there are some problems in clinic as follows. ①The main shortage of covered stents is to occlude small branch vessels. ②Thrombosis and restenosis occur after covered stenting. ③Covered stents increase the volume of the stent, reduce the compliance and flexibility of the stents, and increase the pushing difficulty and vascular injury. ④Covered stents cannot be used in vessels of less than 4 mm.CONCLUSION: Covered stents for intracranial ischemic and hemorrhagic diseases shows significant outcomes, but there are disadvantages. With the clarification of the related theories and the improvement of new material technology, there will be a brighter future of the application of covered stents for treatment of cerebrovascular diseases.

Study on the methods for establishing virtual three-dimensional models of cerebral arteries with the three-dimensional moulding software / 生物医学工程学杂志

This study was conducted to establish the methods of virtual three-dimensional cerebral arteries models by use of three-dimensional moulding software. The virtual models of the cerebral arteries were established using the three-dimensional moulding software of 3D Studio MAX R3 with 46 cases of normal cerebral DSA image as the original. The results showed there was similarity in appearance between the virtual cerebral arteries and DSA image. This is of benefit to understanding the vascular three-dimensional spatial relation in visual sense. Several models of different variant anatomy could be easily established on the copy files of the virtual cerebral arteries model. The virtual model could help learners to create and increase the three-dimensional space concept of arteries and aneurysms in clinical teaching. The results indicated that the virtual three-dimensional cerebral arteries models could display the three-dimensional spatial relation of the cerebral arterial system distinctly, and could serve as a morphologic foundation in the researches on vascular disease.

Preliminary result on pediculoplasty for treatment of vertebral pedicular osteolytic metastasis of lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>Vertebral pedicular metastasis in lung cancer patients are common. This is a preliminary study on methods and clinical application of percutaneous pediculoplasty in the treatment of vertebral pedicular osteolytic metastasis of lung cancer.</p><p><b>METHODS</b>Percutaneous pediculoplasty was performed in 5 lung cancer patients with osteolytic metastasis in 7 vertebral pedicles, 2 cases occurred in thoracic vertebral pedicles and 3 cases occurred in lumbar vertebral pedicles, 2 cases had two loci involved. Under Multislice helical CT guidance, 2.5-5mL of polymethylmethacrylate mixture (ratio of polymer, moner, ultrafluid iodinated oil was 20g:10mL:3mL) had been injected into pathologic pedicles step by step after successful puncture using 13G needle. All cases had been followed-up in 2-5 months.</p><p><b>RESULTS</b>All cases had been successfully punctured. Pain relieved in all 4 cases to some extent after percutaneous pediculoplasty. Two cases had bone-cement leakage, 1 case with leakage into intervertebral foramen which led to nerve radicular pain, the pain disappeared 3 days later after intravenous mannitol and lower dose dexamethasone drips, and another 1 case with minor leakage into vertebral canal but without clinical symptoms. No spondyloptosis occurred in all cases after follow-up.</p><p><b>CONCLUSIONS</b>CT-guided percutaneous pediculoplasty is a minimal injured, effective and safe method for osteolytic vertebral pedicular metastasis of lung cancer.</p>

Embolotherapy for the management of lung cancer with massive hemoptysis / 中国肺癌杂志

<p><b>BACKGROUND</b>To investigate the indication, complication and efficacy of bronchial artery embolization for the management of lung cancer with massive hemoptysis.</p><p><b>METHODS</b>Thirty-eight cases of lung cancer with massive hemoptysis were retrospectively analyzed in our hospital from January 1996 to January 2003. All cases presented with acute hemoptysis from 220 to 980 ml daily, with a mean of 290 ml daily. A digital subtracted bronchial arteriogram was perfomed and bleeding arteries were embolized.</p><p><b>RESULTS</b>Hemoptysis decreased gradually in all cases and ceased in 3 or 4 days after embolization. Recurrence was found only in one case 2 months after embolization and second embolization was applied to control hemoptysis. No serious complications occured.</p><p><b>CONCLUSIONS</b>Bronchial artery embolization is safe and efficient for the management of lung cancer with massive hemoptysis.</p>