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2017 Vol. 40, No. 4
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2017, 40(4): 383-387.
doi: 10.3969/j.issn.1674-4500.2017.04.01
Abstract:
Objective To observe the CT、MRI findings of primary hepatic angiosarcoma (PHA) and analyze its pathological basis. Methods CT images (5 cases) and MR images (1 case) of PHA patients confirmed by histopathology were retrospectively analyzed. The location, size, form, density(signal)and enhancement pattern were evaluated. These findings were explored with histopathology findings. Results In 5 pateints, there were 4 of signle mass type, 1 of multiple mass. The dominant mass demonstrated lobular or round in shape. CT scan showed PHA in low density, within the uneven density. Enhanced scan was progressively strengthened, but it could not be completely filled on the equilibrium phase. One case showed heterogeneous hypointensity at T1WI, markedly hyperintersity at T2WI and DWI. It was not completely filled on equilibrium phase while enhancement were strengthened progressively. The pathological lesions showed hemorrhage, necrosis and fibrosis. Conclusion Imaging features of PHA have certain characteristics. PHA often show single or multiple mass with internal hemorrhage, necrosis, progressive enhancement. It can not be completely filled in delay period. These signs suggest the diagnosis with low specificity. Pathological examination is imprtant to confirm the diagnosis.
2017, 40(4): 388-392.
doi: 10.3969/j.issn.1674-4500.2017.04.02
Abstract:
Objective To explore the clinical effects of cannulated compression screws assist with 3D printing technique in treatment of odontoid fracture of Andersonll A type. Methods Forty patients with odontoid fracture of Anderson ⅡA type in our hospital from January 2014 to January 2017 were selected. They were divided into 2 groups according to the random number table. The observation group (n=21)was treated by 3D printing with annulated compression screws and the control group (n=19) was treated by annulated compression screws. Success rate, operation time, amount of bleeding, X-ray frequency, screw placement frequency, bone healing time, rate of screw loose and JOA, CROM, ASIA score were compared. Results Two groups had the 100% success rate of operation. The operation time, amount of bleeding, X-ray frequency and screw placement frequency of observation group were lower than that of control group (P<0.05). The bone healing time and the rate of screw loose of observation group was less than that of control group (P<0.05). The Japanese Orthopaedic Association Scores (JOA), Cervical range of motion (CROM), American Spinal Injury Association (ASIA) score in preoperative of two groups had no significant difference (P>0.05). The JOA, CROM, ASIA score at a month after operation were higher than preoperative groups (P<0.05). The JOA, CROM, ASIA score at a month after the operation of two groups had no significant difference (P>0.05). Conclusion 3D printing with annulated compression screws can decrease the operation time, amount of bleeding, X-ray frequency and screw placement frequency. It can promte the bone healing, and decrease the rate of screw loose.
2017, 40(4): 393-396.
doi: 10.3969/j.issn.1674-4500.2017.04.03
Abstract:
Objective To explore ultrasound findings of the thyroid hemodynamic parameters in thyroid disorders by micro vascular imaging. Methods Fifty-six patients with untreated thyroid dysfunction and 84 in control group were enrolled. According to the results of serum tests, 56 patients were divided into hyperthyroidism group (n=34) and hypothyroidism group (n=22). The differences of vascularity index among the three groups were analyzed. Results There were significant differences of Vmax（33.89±17.56 cm/s vs 68.23±15.41 cm/s）、Vmin(12.31±7.59 cm/s vs 25.62±9.41 cm/s) and vascularity flow (14.92±10.61 mL/min vs 46.67±10.17mL/min) in 3 groups (P<0.05). Resistive index in 3 groups had no significant differences. Conclusion The hemodynamic parameters of thyroid can reflect the blood flow of hypothyroidism.
2017, 40(4): 397-400.
doi: 10.3969/j.issn.1674-4500.2017.04.04
Abstract:
Objective To study the clinical application value of contrast-enhanced ultrasound combined with fine needle aspiration biopsy in the diagnosis of thyroid nodules. Methods Ninety-eight thyroid nodules from 98 patients in our hospital were observed. Patients were performed with the examination of two-dimensional ultrasound and contrast-enhanced ultrasound.Then they accepted fine needle aspiration biopsy under ultrasound guidance. According to surgical pathology, the accuracy of contrast-enhanced ultrasound and fine needle aspiration biopsy in the diagnosis of thyroid nodules were evaluated. Results In 98 cases of thyroid nodules, 40 cases were surgical pathologic diagnosis of benign nodules, 58 cases of malignant nodules. The sensitivity, specificity and accuracy of contrast-enhanced ultrasound and fine needle aspiration in diagnosis of thyroid nodules were 72%, 68%, 70% and 78%, 73%, 76%. Contrast-enhanced ultrasound combined with fine needle biopsy in the diagnosis of thyroid nodules got the sensitivity of 91%, specificity of 90%, accuracy of 90%. The sensitivity specificity and accuracy of thyroid nodule diagnosis were significantly improved by combination of two methods of examination, and the difference was statistically significant（P<0.05）. Conclusion Contrast-enhanced ultrasound combined with fine needle aspiration biopsy can be accurate and safe to judge benign and malignant thyroid nodules.It has important clinical significance for the diagnosis of thyroid nodule.
2017, 40(4): 401-404.
doi: 10.3969/j.issn.1674-4500.2017.04.05
Abstract:
Objective To explore spatial position of the acute lacunar infarction lesions in corticospinal tract, the relationship between limb motor function and acute lacunar infarction, and assess the clinical value of magnetic resonance diffusion tensor imaging (DTI) in prognosis of patients with acute lacunar infarction. Methods Forty cases of lacunar infarction in patients with acute were performed with the conventional MRI and DTI examination at the same time. Fractional anisotropy and the measurement of pseudocolor value FA infarction, reconstruction bilateral cortical spinal tract were analyzed.In the spatial position of CST, the infarct were divided into 3 groups: fiber bundle, fiber bundle and fiber bundle.Fugl-Meyer motor function score was assessed before each MR examination. Relationship between the location of the infarct and the Fugl-Meyer motor function score was analyzed. Results There was a negative correlation between the increase of Fugl-Meyer exercise score and the lesion before and after the rehabilitation treatment (P<0.01). Conclusion DTI diffusion of water molecules through the spatial relationship of acute lacunar infarction foci and the CST anisotropy and DTT classification can accurately display the degree of injury of the corticospinal tract, cerebral infarction patients. It would provide a clear basis for the clinical treatment and prognosis of patients with cerebral infarction.
2017, 40(4): 405-408.
doi: 10.3969/j.issn.1674-4500.2017.04.06
Abstract:
Objective To assess the value of diffusion weighted magnetic resonance imaging combined with dynamic enhancement technique in identification of benign and malignant breast lesions. Methods Seventy patients with breast lumps confirmed by pathology were retrospectively analyzed.The patients were underwent with DW imaging examination and dynamic contrast-enhanced imaging. The diagnosis result were compared with pathologic results. Results The 70 patients had 77 lesions. DCE-MRI had 3(12%) typeⅠcurving patterns, 7(28%) typeⅡ curving patterns and 15(60.0%) type Ⅲ curving patterns in the malignant group.In benign group, there were 35(67%) typeⅠcurving patterns, 11(21%) type Ⅱ curving patterns and 6(12%) type Ⅲ curving patterns. Curving pattern of TypeⅠand type Ⅲ were significantly different (P<0.05). The difference of ADC values between benign and malignant tumor was significant (P=0.000). The curve of ROC analysis showed DCE-MRI with 85.0% sensitivity, 60% specificity and 0.723 AUC. The sensitivity, specificity, AUC of ADC were 88%, 78% and 0.83, respectively. The combination of two technique had sensitivity of 90%, specificity of 98% and AUC of 0.943. Conclusion Compared to DCE-MRI, ADC have a high accuracy in diagnosis of benign and malignant breast tumor. The application of DWI and DEC-MRI can improve the accuracy of diagnosis of breast tumor.
2017, 40(4): 409-412.
doi: 10.3969/j.issn.1674-4500.2017.04.07
Abstract:
Objective To evaluate the accuracy of breast masses ultrasonic features in diagnostic of breast carcinoma. Methods Theultrasonic features of suspicious breast masses in 108 female patients with breast resection in our hospital from January 2014 to December 2016 were retrospectively analyzed. We analyzed the mass size, location, form, border, internal echo, calcification, posterior echo, "taller-than-wide" shape, arterial spectrum and the axillary lymph node. The sensitivity, specificity, postive predictive values, negative predictive values, diagnostic coincidence rate of each ultrasonic feature were calculated by comparing with postoperatic pathological results . Results A total of 117 suspicious masses were found in 108 patients. Seventy cases were diagnosed as breast cancer and 10 cases with ipsilateral axillary lymph node enlargement.There were significant differences in the size of the tumor and ultrasound characteristics (P<0.05). Conclusion The highest diagnostic coincidence ratio of breast carcinoma is calcification within the tumor, acoustic attenuation behind the masses, "taller-than-wide" shape≥1.
2017, 40(4): 413-415.
doi: 10.3969/j.issn.1674-4500.2017.04.08
Abstract:
Objective To investigate the prognostic factors of traumatic epidural hematoma in children. Methods The clinical features, imaging findings and therapeutic method of 41 cases with epidural hematoma in children who were admitted to our hospital from 2013 to 2016 were analyzed. The prognosis in different time of surgery and the factors affecting the prognosis of the operation were evaluated. Results Forty-one cases were treated by craniotomy, 34 cases with postoperative recovery, 3 cases with mild disability and 4 cases dead. The differences of poor prognosis ratio in children between the 2 groups were significant. The poor prognosis ratio in 6-24 h group was significant higher than that of <6 h group. Conclusion Timing of surgery, severity of intracranial injury, epidural hematoma location and the operation have a great impact on the prognosis of the children.
Laparoscopic transabdominal preperitoneal herniorrhaphy in treatment of incarcerated inguinal hernia
2017, 40(4): 416-419.
doi: 10.3969/j.issn.1674-4500.2017.04.09
Abstract:
Objective To explore the clinical value of laparoscopic transabdominal preperitoneal herniorrhaphy in treatment of incarcerated inguinal hernia. Methods Clinical data of 44 patients with acute incarcerated inguinal hernia who underwent herniorrhaphy in our hospital from January 2015 to December 2016 were retrospectively analyzed．According to different operation methods, the patients were divided into observation group (n=19) and control group (n=25). The observation group were received TAPP herniorrhaphy, and the control group were received open preperitoneal herniorrhaphy. The clinical curative effect of two groups were compared. Results Patients in two groups were fulfilled the operation successfully. The operation time and intraoperative blood loss of the observation group were 60.13±9.52 min and 6.00±2.27 mL, respectively. The control group were 60.25±10.71 min and 7.25±3.92 mL, respectively.The difference in 2 groups were not significant (P>0.05). The differences of postoperative VAS scores, postoperative intestinal recovery time and hospitalization time in observation group and control group were significant (2.63±1.06, 18.88±7.83 h, 3.19±0.60 d; 5.75±1.67, 41.63±7.13 h, 5.38±1.13 d;P<0.05). The incidence of postoperative complications in the observation group was 16%(3 cases of seroma) and the control group was 28% (3 cases of seroma, 2 cases of incision fat liquefaction, 1 case of chronic pain and 1 case of recurrence). The difference was not significant (P>0.05). Conclusion With correct indication selection, TAPP will be safely and effectively applied on patients with acute incarcerated inguinal hernia. It has small trauma, less pain and quick recovery.
2017, 40(4): 420-423.
doi: 10.3969/j.issn.1674-4500.2017.04.10
Abstract:
Objective To investigate the effects of high intensity focused ultrasound（HIFU）combined laparoscopic myomectomy (LM) treating uterine myoma of intramural muscle. Methods Thirty cases of uterine myoma of intramural muscle were administrated to LM (laparoscopic group) and 30 cases of uterine myoma of intramural muscle were treated with LM combined with HIFU（combination group）. Operation time, intraoperative bleeding volume, anal exhaust time, decreasing value of hemoglobin, time of off-bed, wound healing time, postoperative complication rate, hospital staying time, intensity of postoperative pain, recovery time of menstruation, ovulation rate, pregnancy rate and recurrence rate were compared. Results Operation time, intraoperative bleeding volume, anal exhaust time, decreasing value of hemoglobin and postoperative complication rate of combined group were significant lower than that of laparoscopic group (P<0.05). There were no statistically difference in time of off-bed, wound healing time, postoperative complication rate, hospital staying time, intensity of postoperative pain, recovery time of menstruation, ovulation rate, pregnancy rate and recurrence rate (P>0.05). Conclusion HIFU jointing LM treating uterine myoma of intramural muscle can shorten operation time, reduce intraoperative bleeding volume and decrease postoperative disease rate. It is worth advocating in clinic.
2017, 40(4): 424-429.
doi: 10.3969/j.issn.1674-4500.2017.04.11
Abstract:
Objective To investigate the association between miR-146a gene polymorphism and Ischemic stroke (IS) in Chinese population. Methods Publications in PubMed, Ovid, Cochrane Library EMBASE, CNKI, VIP and Wangfang Datebase were retrieved up to December 2015. Studies of investigating association between miR-146aC>G (rs2910164) and IS in Chinese population were included. Quality of inclubed studies were evaluated by a Newcastle-Ottawa Scale (NOS) tool.The valied data were extracted and analyzed by Review Manager5.0 software. Results Six studies involving 1945 patients of IS and 2456 controls were included. No association between miR-146a rs2910164 polymorphism and the risk of IS was observed [G vs C: OR=0.97, 95%CI: (0.89-1.06), P=0.06]; [GG vs CC: OR=0.99, 95%CI: (0.82-1.18), P=0.88]; [ GC vs CC: OR=1.02, 95%CI (0.90-1.17), P=0.75]; [GG+GC vs CC: OR=1.01, 95%CI (0.90-1.15), P=0.82]. Conclusion The Meta-analysis suggested that the rs2910164 polymorphism in miR-146a is not associated with IS in Chinese population.
2017, 40(4): 430-435.
doi: 10.3969/j.issn.1674-4500.2017.04.12
Abstract:
Objective To systematically review the effect of ranibizumab joint laser photocoagulation on diabetic macular edema. Methods Databases including PubMed, EMbase, Cochrane Library, CBM, Wang Fang Data and CNKI were electronically searched to collect randomized controlled trials(RCTs) about the effect of ranibizumab joint laser photocoagulation in treatment of diabetic macular edema from inception to December 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. The meta-analysis was performed through RevMan 5.3 software. Results A total of 7 RCTs involving 518 patients and 556 eyes were included. The results of meta-analysis showed that: BCVA measured values in joint group were higher than the control group on 1, 3, 6 months. The differences were significant [SMD=-0.37,95%CI(0.05, 0.69), P=0.02; SMD=1.17, 95%CI(0.56, 1.78), P=0.0002; SMD=2.34, 95% CI(0.16, 4.51), P=0.04]. With the increase of time, the more visual acuity were on joint group. CMT measured values in joint group were significant less than the control group on 1, 3, 6 months [SMD=-1.34,95%CI (-2.41, -0.28), P=0.01; SMD=-1.36, 95%CI (-2.37, -0.34), P=0.009; SMD=-1.05, 95% CI (-1.34, -0.76), P<0.00001]. Conclusion Ranibizumab joint grid photocoagulation therapy for the treatment of diabetic macular edema than ranibizumab or grid photocoagulation, less adverse reaction and no serious adverse reactions. It is worth to apply grid photocoagulation and generalization in treatment of diabetic macular edema.
2017, 40(4): 436-439.
doi: 10.3969/j.issn.1674-4500.2017.04.13
Abstract:
Objective To explore the expression of α-Thalassemia/Mental Retardation Syndrome X-linked (ATRX) and molecular genetic alterations of chromosome 1p/19q in diagnosis of astrocytoma, oligodendroglioma and oligoastrocytoma. Methods We analyzed ATRX expression status by immunohistochemistry in 53 patients with astrocytoma, oligodendroglioma or oligoastrocytoma.The molecular genetic alterations of chromosome 1p/19q with fluorescence in situ hybridization in these tumors were analyzed. Results The mutation rate of ATRX in astrocytoma, oligodendroglioma or oligoastrocytoma were 60.0%, 44.4%, 50.0%; The loss rates of chromosome 1p, 19q and 1p/19q were0%, 0%, 0% in astrocytoma; 54.5%, 0%, 45.5% in oligodendroglioma and 12.5%, 0%, 0% in oligoastrocytoma respectively, with significant differences between oligodendroglioma and non-oligodendroglioma (P=0.032). Conjoint analysis of ATRX mutation and loss rates of chromosome 1p, 19q and 1p/19q status defined 3 subtypes of gliomas, with significant difference (P=0.046, P=0.003). Conclusions The loss of 1p/19q is mainly occurred in oligodendroglioma, which can be used as a oligodendroglioma marker in diagnosis. There are significant differences between astrocytoma and oligoastrocytoma about the molecular genetic alterations.
2017, 40(4): 440-444.
doi: 10.3969/j.issn.1674-4500.2017.04.14
Abstract:
Objective To explore the correlation between CD8+CD28-Treg and intracranial pressure in craniotomy patients with craniocerebral injury. Methods Fifty-six patients with craniocerebral injury surgical operation were chosed as observation group (group A), 38 cases with acute massive cerebral infarction who underwent decompressive craniectomy were chosed as the positive control (group B), and 40 healthy volunteers were chosed as the negative control group (group C). CD8+CD28-Treg, cytokine interleukin 10 (IL-10) and transforming growth factor beta 1 (TGF-beta 1) percentage in peripheral blood and cerebrospinal fluid were compared. Intracranial pressure, CD8+CD28-Treg, IL-10 and the TGF-beta 1 of Group A in different time were compared, with correlation analyzed. Results Preoperative CD8+CD28-Treg, IL-10 and TGF-beta 1 of group A were lower than that of group B and C (P<0.05), but no significant difference was found between B and C (P>0.05). With the deduction of the illness, intracranial pressure of group A droped to normal level gradually, and CD8+CD28-Treg, IL-10 and TGF-beta 1 in peripheral blood and cerebrospinal fluid were gradually recovered.Correlation analysis showed that intracranial pressure had a negative correlation with CD8+CD28-Treg, IL-10 and TGF-beta 1. Conclusion CD8+CD28-Treg cells and its cytokine reduction are important phenomenon of immunology in craniocerebral injury. There is a close relationship with elevated intracranial pressure.
Crrelation of serum uric acid level with new emerging cardiovascular disease and diabeticnephropathy
2017, 40(4): 445-448.
doi: 10.3969/j.issn.1674-4500.2017.04.15
Abstract:
Objective To explore the relationship between serum uric acid level with new emerging cardiovascular disease and diabetic nephropathy in patients with type II diabetes. Methods A total of 280 patients with type II diabetic in xi’an central hospital from November 2014 to November 2016 were chosed as subject. Accrording to the level of serum uric acid, patients were divide into hyperuricemia group and normal uric acid group, with 140 cases in each group. Cardiovascular and renal damage indexes were detected in two groups, which were used to evaluate the relationship between serum uric acid level with newly emerging cardiovascular disease and diabetic nephropathy. Results The carotid artery medial thickness (IMT), urinary albumin/creatinine ratio (ACR) and the three oil ester (TG) in hyperuricemia group were significantly higher than those in normal uric acid group (P<0.01). The morbidity and occurrence time of cardiovascular disease and diabetic nephropathy in 2 groups showed significant differences (P<0.05). Multiple regression analysis showed that serum uric acid level was the main influence factor of IMT and ACR. Conclusion The relationship between serum uric acid level with new emerging cardiovascular disease and diabetic nephropathy was positive. Wish a rising of serum uric acid level, the morbidity of new emerging cardiovascular disease and diabetic nephropathy is higher and the occurrence time is earlier.
2017, 40(4): 449-452.
doi: 10.3969/j.issn.1674-4500.2017.04.16
Abstract:
Objective To explore the risk factors associated with recurrence of benign breast phyllodes tumors and the feasibility of Mammotome operation. Methods The clinic and pathological data were retrospectivly analyzed in 113 cases with benign PT who received surgery in the Maternal and Children Healthcare Hospital of Foshan from Jan 2007 to May 2016. There were 58 cases of open surgery and 55 cases of Mammotome surgery. Results The recurrence rate in two groups were not significantly different. The differences of age and tumor size in 2 group were significant.The average age were 38.8±8.1 and 34.9±8.1 years. The average tumor diameter were 3.6±1.3 cm and 2.0±0.7 cm. The differences of tumor size and mitosis in recurrence group and no recurrence group were significant. However, difference of recurrence was not significant between different surgery choice in the small tumor group (P=0.67). Conclusion Recurrence of PT is related to pathological features. Mammotome treatment is safe and feasible when tumor size <2.5 cm.
2017, 40(4): 453-456.
doi: 10.3969/j.issn.1674-4500.2017.04.17
Abstract:
Objective To compare the changes of serum troponin and systolic and diastolic function in patients with left breast cancer before and after radiotherapy,analyze the effect of radiotherapy on cardiac function, and observe the preventive effect of levocarnitine on cardiac toxicity induced by radiotherapy after left radical mastectomy. Methods Seventy patients with left breast cancer underwent radiotherapy after radical surgery were randomly assigned with treatment group of 35 cases and control group of 35 cases. The treatment group in the radiotherapy treatment was performed with levocarnitine of 1-2 g/d intravenous infusion. The control group was not treated with myocardial protective drugs. All patients underwent ipsilateral supraclavicular region and chest wall intensity modulated radiotherapy: 2 Gy/(times· d), 5 d/week, 5 weeks. All radiotherapy patients were examined for troponin T detection, ultrasound examination of cardiac systolic and diastolic function before radiotherapy, radiotherapy for 2 weeks, the end of radiotherapy, 4 weeks after radiotherapy. Troponin T, diastolic and diastolic function of the two groups before and after radiotherapy were compared. Results CTnT after radiotherapy was significantly higher than that before radiotherapy (F=292.548, P=0.000). The protective effect of cTnT on the treatment group was better than that of the control group (F=88.960, P=0.000). Left atrial contraction end diameter (LADs), Left ventricular end diastolic diameter (LVDd), ejection fraction (EF), short axis shortening (FS), early mitral valve diastolic peak velocity (E), atrial systolic peak velocity (A), E/A, mitral annulus ventricular septal systolic peak velocity (Sa), systolic peak velocity (Sa), early diastolic peak velocity (Ea), diastolic velocity (Aa), Ea/Aa after radiotherapy were significantly lower than that before radiotherapy. There was no significant difference of LADS, E, A, E/A, Saoutside, Ea, Aa, Ea/Aa between the treatment group and the control group (P>0.05). The protective effect of LVDd, EF, FS and Sainterval side on the systolic and diastolic index of the treatment group was better than that of the control group (P<0.05). Conclusion Cardiac function of left breast cancer is significantly impaired after radiotherapy. Radiotherapy combined with application of levocarnitine during the radiotherapy can effectively prevent cardiac toxicity induced by radiotherapy after radical surgery.
2017, 40(4): 457-459.
doi: 10.3969/j.issn.1674-4500.2017.04.18
Abstract:
Objective To summarize the experience of surgical treatment of hepatic cystic echinococcosis. Methods An retrospective analysis was made in 87 cases of hepatic cystic echinococcosis in recent 3 years. The patients were divided into two groups: endocystectomy and subtotal pericystectomy group (64 patients) and total pericystectomy group (23 patients). Results Endocystectomy and subtotal pericystectomy group was significantly lower than total pericystectomy group in blood loss and operation time (P<0.05). Total pericystectomy group was superior than endocystectomy and subtotal pericystectomy group in the postoperative complications with residual cavity and draining time (P<0.05). There was no significant difference in the length of hospital stay and local recurrence between the two groups (P>0.05). Conclusion The two kinds of surgical management to treat hepatic cystic echinococcosis have their advantages and disadvantages. The operation procedure should be chosen according to patient’s condition, imaging data and local medical level.
2017, 40(4): 460-462.
doi: 10.3969/j.issn.1674-4500.2017.04.19
Abstract:
Objective To investigate the blood coagulation function in patients with sepsis and the correlation of procalcitonin change trend with prognosis. Methods The patients with sepsis in emergency ICU of our hospital in January 2015-June 2016 were choosed as research object. Patients were divided into death group and alive group according to prognosis. Plasma prothrombin time (PT), activated partial clotting enzyme live time (APTT), thrombin time (TT), fibrinogen (FIB) and serum calcitonin (PCT) level of 2 groups were detected. Results The difference of 2 groups was significantly(P<0.05). ROC curve showed the best cut-off point of PCT was 34.24, with the area under the curve (AUG) of 93.4, sensitivity of 87.1%, specific degree of 93.1%; best cut-off point of PT was 14.75, with AUG of 72.5, sensitivity of 54.8%, the specific degree of 93.1%; best cut-off point of INR was 1.305, with AUG of 72, sensitivity of 48.4%, the specific degree of 89.7%; best cut-off point of APTT was 39.2, with AUG of 71.7, sensitivity of 67.7%, the specific degree of 86.2%; best cut-off point of Fbg was 3.315, with AUG of 90.3, sensitivity of 58.6% and specific degree of 93.1%. Conclusion Procalcitonin and blood coagulation function are closely related to the severity of sepsis. They can be used as an important index of disease monitoring and prognosis.
2017, 40(4): 463-465.
doi: 10.3969/j.issn.1674-4500.2017.04.20
Abstract:
Objective To investigate the value of interleukin 6 (IL-6), calcitonin (PCT) and white blood cell (WBC) in diagnosis and treatment of neonatal intrauterine bacterial infection. Methods Neonates with high risk factors of intrauterine infection in obstetrics department of Zhongshan People’s Hospital in 2014-2015 were chosed. They were divided into infection group (34 cases) and no infection group (102 cases). The sensitivity and specificity of serum IL-6, PCT and WBC levels in two groups were tested. Changes of IL-6, PCT and WBC levels before and after antibiotic application in infection group were analyzed. Results IL-6, PCT, the WBC levels in infection group were higher than that of no infection group (P<0.05). ROC curve showed: sensitivity of IL – 6 was 83.3%, specificity of PCT was 84.2%, specificity of WBC was 91.2%; sensitivity of IL-6 in combination with PCT was 90.9%. The differences of IL-6, PCT and WBC before and after treatment in infection group were significant (P<0.05). Conclusion IL-6, PCT and WBC can be used as an important index for the diagnosis of intrauterine bacterial infection, and used as a guideline for the use of antibiotics in the course of disease monitoring.
2017, 40(4): 466-468.
doi: 10.3969/j.issn.1674-4500.2017.04.21
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Objective To explore the clinical and aesthetic effect of immediate implant immediate prosthesis and delayed implant delayed prosthesis on single maxillary anterior teeth. Methods Sixty cases who need for single maxillary anterior dental implants were randomly divided into immediate implantation group (n=30) and delayed implant group (n=30). The 3 years implant success rate, postoperative 3 years after implant bone absorption and Pink Esthetic Score (PES) and White Esthetic Score (WES) were compared. Results The differences of graft success rate and postoperative 3 years after implant bone resorption in 2 group were not significant (P>0.05). PES and WES score in immediate implantation group were higher than that of delayed implant group (P<0.05). Conclusion Compared to conventional repair, immediate implant and restoration can improve the aesthetic effective. The success rate of planting and the bone resorption around implants have no significant difference. It has a certain clinical value.
2017, 40(4): 469-473.
doi: 10.3969/j.issn.1674-4500.2017.04.22
Abstract:
In recent years, many studies have demonstrated that miRNA could act on the development of spermatozoa. It had a certain relationship with male fertility. The targeted regulation of miR-122 had an effect on the development of sperm. The hsa-miR-629-3p, hsa-miR-335-5p, hsa-miR-885-5 and hsa-miR-152-3p were closely related to sperm motility and density. The disorder of the FMRP-miR-383 regulatory pathway lead to male infertility. The miR-27、miR-34c-3p inhibited the expression of CRISP2 and PLCXD3 proteins respectively, which affected the morphology and vitality of sperm. In addition, the deletion of miR34b/449 locus could lead to the occurrence of asthenospermia. This article reviews the effect of miRNA on spermatogenesis, the relationship between miRNA and male infertility and miRNA in patients with weak spermia.
In recent years, many studies have demonstrated that miRNA could act on the development of spermatozoa. It had a certain relationship with male fertility. The targeted regulation of miR-122 had an effect on the development of sperm. The hsa-miR-629-3p, hsa-miR-335-5p, hsa-miR-885-5 and hsa-miR-152-3p were closely related to sperm motility and density. The disorder of the FMRP-miR-383 regulatory pathway lead to male infertility. The miR-27、miR-34c-3p inhibited the expression of CRISP2 and PLCXD3 proteins respectively, which affected the morphology and vitality of sperm. In addition, the deletion of miR34b/449 locus could lead to the occurrence of asthenospermia. This article reviews the effect of miRNA on spermatogenesis, the relationship between miRNA and male infertility and miRNA in patients with weak spermia.
2017, 40(4): 474-477.
doi: 10.3969/j.issn.1674-4500.2017.04.23
Abstract:
Rhabdomyolysis (RM) is a group of clinical syndromes.It refers to the destruction and disintegration of striated muscle caused by various causes. It makes creatine kinase, myoglobin and other intracellular components enter into the blood circulation; causes environmental disorder in body and even acute renal failure. The majority of RM have a good prognosis and it will be greatly risen when it develops ARF. Studies have shown that about 15%-40% of RM patients may concurrent with ARF, and the mortality were up to 20%. Definite etiology and complication are the key to determine the prognosis of the patients. In recent years, many researchers have done a series of animal experiments and clinical studies in RM resulting from drugs, food, infection and endocrine metabolic disease. But due to the complex pathomechanism and atypical clinical manifestation of RM, it is still easy to misdiagnosis and missed diagnosis in clinical. So, we should explore the etiology, pathogenesis and its reasonable and effective treatment. In this paper, we reviewed the clinical research progress in etiology, pathogenesis and blood purification therapy of RM aiming to exploit new views for clinical doctors and make sufficient preparation for earlier prevention, discovery and treatment.
Rhabdomyolysis (RM) is a group of clinical syndromes.It refers to the destruction and disintegration of striated muscle caused by various causes. It makes creatine kinase, myoglobin and other intracellular components enter into the blood circulation; causes environmental disorder in body and even acute renal failure. The majority of RM have a good prognosis and it will be greatly risen when it develops ARF. Studies have shown that about 15%-40% of RM patients may concurrent with ARF, and the mortality were up to 20%. Definite etiology and complication are the key to determine the prognosis of the patients. In recent years, many researchers have done a series of animal experiments and clinical studies in RM resulting from drugs, food, infection and endocrine metabolic disease. But due to the complex pathomechanism and atypical clinical manifestation of RM, it is still easy to misdiagnosis and missed diagnosis in clinical. So, we should explore the etiology, pathogenesis and its reasonable and effective treatment. In this paper, we reviewed the clinical research progress in etiology, pathogenesis and blood purification therapy of RM aiming to exploit new views for clinical doctors and make sufficient preparation for earlier prevention, discovery and treatment.
2017, 40(4): 478-481.
doi: 10.3969/j.issn.1674-4500.2017.04.24
Abstract:
Cerebral small vessel disease refers to a series of syndrome caused by the abnormality of intracranial small vessels.The main clinical manifestation is cognitive decline. CSVD is insidious onset, usually accompanies with neurodegenerative disease. Medical image is necessary to the diagnosis of CSVD. The global neuroimaging experts put forward a handbook in 2012, establishing 6 terms of neuroimaging critical damages, such as recent small subcortical infarcts, lacune of presumed vascular origin, white matter hyperintensities of presumed vascular origin, perivascular space, cerebral microbleed and brain antroph. This article will summarize the new progress of CSVD in imaging.
Cerebral small vessel disease refers to a series of syndrome caused by the abnormality of intracranial small vessels.The main clinical manifestation is cognitive decline. CSVD is insidious onset, usually accompanies with neurodegenerative disease. Medical image is necessary to the diagnosis of CSVD. The global neuroimaging experts put forward a handbook in 2012, establishing 6 terms of neuroimaging critical damages, such as recent small subcortical infarcts, lacune of presumed vascular origin, white matter hyperintensities of presumed vascular origin, perivascular space, cerebral microbleed and brain antroph. This article will summarize the new progress of CSVD in imaging.
2017, 40(4): 482-485.
doi: 10.3969/j.issn.1674-4500.2017.04.25
Abstract:
Atherosclerosis is a major cause of coronary heart disease(CHD), cerebral infarction and peripheral vascular disease. It is a serious threat to human health and disease ,especially CHD. Atherosclerosis is one of the most important factor , mainly due to various reasons that cause vascular endothelial cell damage and destroy its barrier function. As a consquence, many kinds of macrophages in the blood invade lining widely to form the atheromatous plaque with a mass of lipids. Eventually it will evolve into vascular remodeling. Sometimes, it may cause plaque rupture if the situation develops further. Matrix metalloproteinase is a group of enzymes that can almost degrade all off constituents of Vascular extracellular matrix. It can be expressed excessively in the areas with plentiful atherosclerotic plaques and degrade matrix to cause plaque rupture, bleeding and form Secondary thrombosis. At last, acute coronary syndrome occurs. This article mainly make a literature review about the relationship between serum matrix metalloproteinase levels and atherosclerosis and plaque rupture emphatically.
Atherosclerosis is a major cause of coronary heart disease(CHD), cerebral infarction and peripheral vascular disease. It is a serious threat to human health and disease ,especially CHD. Atherosclerosis is one of the most important factor , mainly due to various reasons that cause vascular endothelial cell damage and destroy its barrier function. As a consquence, many kinds of macrophages in the blood invade lining widely to form the atheromatous plaque with a mass of lipids. Eventually it will evolve into vascular remodeling. Sometimes, it may cause plaque rupture if the situation develops further. Matrix metalloproteinase is a group of enzymes that can almost degrade all off constituents of Vascular extracellular matrix. It can be expressed excessively in the areas with plentiful atherosclerotic plaques and degrade matrix to cause plaque rupture, bleeding and form Secondary thrombosis. At last, acute coronary syndrome occurs. This article mainly make a literature review about the relationship between serum matrix metalloproteinase levels and atherosclerosis and plaque rupture emphatically.
2017, 40(4): 486-488.
doi: 10.3969/j.issn.1674-4500.2017.04.26
Abstract:
Postoperative infection of tibial plateau fractures is one of the most serious complications after surgery, which seriously affects the health of patients and increases the cost of treatment. The risk of infection caused by many factors, including systemic factors, the soft tissue around thefracture and fracture type, surgical operation is the norm, the rational use of antibiotics, , each factor often influences each other, this paper aims to make a review of the related risk factors, so as to help the clinical better prevention of postoperative infection of fracture.
Postoperative infection of tibial plateau fractures is one of the most serious complications after surgery, which seriously affects the health of patients and increases the cost of treatment. The risk of infection caused by many factors, including systemic factors, the soft tissue around thefracture and fracture type, surgical operation is the norm, the rational use of antibiotics, , each factor often influences each other, this paper aims to make a review of the related risk factors, so as to help the clinical better prevention of postoperative infection of fracture.
2017, 40(4): 489-493.
doi: 10.3969/j.issn.1674-4500.2017.04.27
Abstract:
Primary immune thrombocytopenia is a kind of acquired autoimmune hemorrhagic disease. The etiology is still unknown. The pathogenesis of the disease is mainly related to loss of immune system with excessive platelet destruction and insufficient production. T lymphocyte mediated adaptive immune response. B lymphocyte exert specific humoral immunity by producing antibodies. NK cells play an important role in innate immune response by killing certain cells directly. Three types of cells are all participate in the body's immune response and immune regulation. We reviewed current progress of T lymphocytes, B lymphocytes, NK cells and cytokines in the pathogenesis of primary immune thrombocytopenia. Immune dysfunction is important in the pathogenesis of ITP. The occurrence of ITP is caused by different mechanisms of T lymphocytes, B cells and NK cells action. The detection of peripheral blood lymphocyte subsets can improve the laboratory diagnosis of ITP. It has an important guiding significance in clinical treatment.
Primary immune thrombocytopenia is a kind of acquired autoimmune hemorrhagic disease. The etiology is still unknown. The pathogenesis of the disease is mainly related to loss of immune system with excessive platelet destruction and insufficient production. T lymphocyte mediated adaptive immune response. B lymphocyte exert specific humoral immunity by producing antibodies. NK cells play an important role in innate immune response by killing certain cells directly. Three types of cells are all participate in the body's immune response and immune regulation. We reviewed current progress of T lymphocytes, B lymphocytes, NK cells and cytokines in the pathogenesis of primary immune thrombocytopenia. Immune dysfunction is important in the pathogenesis of ITP. The occurrence of ITP is caused by different mechanisms of T lymphocytes, B cells and NK cells action. The detection of peripheral blood lymphocyte subsets can improve the laboratory diagnosis of ITP. It has an important guiding significance in clinical treatment.
2017, 40(4): 494-496.
doi: 10.3969/j.issn.1674-4500.2017.04.28
Abstract:
Objective To explore CT features of pedunculated hepatocellular carcinoma(PHCC) and improve the diagnostic level of PHCC. Methods The clinical manifestations, laboratory tests and multi-slice spiral CT features of 2 cases with PHCC were retrospectively analyzed with literatures analysis. Results It was difficult to accurately diagnose PHCC based on clinical manifestations, laboratory test, Conventional ultrasound and CT plain scan. Some obvious PHCC have special features in CT images . Preoperative CT can prompt diagnosis. Conclusion CT scan showed a low density large liver periphery with clear edge mass.Dynamic enhanced CT scan showed blood supply from the intrahepatic vessels. It generally conform to the " fast forward and fast out” performance. It should be diagnosed as PHCC.
2017, 40(4): 497-500.
doi: 10.3969/j.issn.1674-4500.2017.04.29
Abstract:
Objective To analyze the diagnosis and treatment of pregnancy complicated with renal giant hamartoma, and to explore the causes of misdiagnosis and misdiagnosis, and to provide reference for clinical treatment. Methods The clinical data, diagnosis and treatment of one cases of pregnancy complicated with giant renal hamartoma were retrospectively analyzed and analyzed in combination with related literature. Results After cesarean section abdominal palpated a mass, ultrasound retroperitoneal mass source, CT may not consider liposarcoma, hamartoma exclusion. For tumor enucleation in 4 months after delivery, postoperative pathology confirmed hamartoma. ConclusionAt the same time, threatening the pregnancy rupture in pregnant women and fetal life huge renal hamartoma, so women should perform physical examination before pregnancy, with renal hamartoma history of pregnant women should strengthen the monitoring of the tumor during pregnancy, diagnosis physicians need to strengthen the understanding of these diseases.
Objective To analyze the diagnosis and treatment of pregnancy complicated with renal giant hamartoma, and to explore the causes of misdiagnosis and misdiagnosis, and to provide reference for clinical treatment. Methods The clinical data, diagnosis and treatment of one cases of pregnancy complicated with giant renal hamartoma were retrospectively analyzed and analyzed in combination with related literature. Results After cesarean section abdominal palpated a mass, ultrasound retroperitoneal mass source, CT may not consider liposarcoma, hamartoma exclusion. For tumor enucleation in 4 months after delivery, postoperative pathology confirmed hamartoma. ConclusionAt the same time, threatening the pregnancy rupture in pregnant women and fetal life huge renal hamartoma, so women should perform physical examination before pregnancy, with renal hamartoma history of pregnant women should strengthen the monitoring of the tumor during pregnancy, diagnosis physicians need to strengthen the understanding of these diseases.
2017, 40(4): 501-503.
doi: 10.3969/j.issn.1674-4500.2017.04.30
Abstract:
The paper reported a case of pituitary stalk interruption syndrome (PSIS), which is characterized by abnormal developmentof genitalia and high height. It was analyzed witgh literature review. Two main pathogenic mechanisms of the disease were found: the injury of the hypothalamic pituitary region; genetic factors. However, the virulence genes have not been located yet. The diagnostic criteria of PSIS were: absence or thinning of the pituitary stalk, high signal ectopia of the pituitary gland and hypoplasia of the pituitary gland.
The paper reported a case of pituitary stalk interruption syndrome (PSIS), which is characterized by abnormal developmentof genitalia and high height. It was analyzed witgh literature review. Two main pathogenic mechanisms of the disease were found: the injury of the hypothalamic pituitary region; genetic factors. However, the virulence genes have not been located yet. The diagnostic criteria of PSIS were: absence or thinning of the pituitary stalk, high signal ectopia of the pituitary gland and hypoplasia of the pituitary gland.
2017, 40(4): 504-507.
doi: 10.3969/j.issn.1674-4500.2017.04.31
Abstract:
Objective To investigate the effect of different exercise time on improving the effect of drug cleaning on the intestinal tract, and to optimize the intestinal cleansing program and improving the accuracy of colonoscopy. Methods Sixty hospitalized patients were enrolled who needed to undergo colonoscopy from February 20 to 2017 in Guangdong Province in September 2017. There were 41 males and 19 females aged 25~83 years (P>0.05). The patients were randomly divided into 3 groups: group A, group B and group C (n=20). No significant difference were found between the two groups for gender composition and age (P>0.05). Boston Intestinal Preparation Scale were used to compare the intestinal cleanliness between 3 groups. The adverse effects of laxatives and the tolerance to exercise were compared. Results The bowel cleanliness of patients in the three groups were significantly different (P<0.001). The differences of adverse effects on laxatives in 3 groups were not significant (P=0.067). C group had the worst tolerance to exercise (P<0.05). Conclusion Walking 30-60 min after oral administration of compound polyethylene glycol is an effective method for intestinal preparation. It is help for colonoscopy.
2017, 40(4): 508-510.
doi: 10.3969/j.issn.1674-4500.2017.04.32
Abstract:
This article introduced the complications of exchanging the single-J-stent, reported the first case of hemorrhoea in exchanging the single-J-stent after ureterocutaneostomy. According to the nursing situation of postoperative patients, this paper comprehensively analyzed the causes of hematuria and systematically reviewed the factors for recurrence of hematuria in patients after radical resection of bladder cancer. Essentials of care in patients undergoing cutaneous ureterostomy and its significance for diagnosis and nursing of patients with cutaneous ureterostomy were explored.
This article introduced the complications of exchanging the single-J-stent, reported the first case of hemorrhoea in exchanging the single-J-stent after ureterocutaneostomy. According to the nursing situation of postoperative patients, this paper comprehensively analyzed the causes of hematuria and systematically reviewed the factors for recurrence of hematuria in patients after radical resection of bladder cancer. Essentials of care in patients undergoing cutaneous ureterostomy and its significance for diagnosis and nursing of patients with cutaneous ureterostomy were explored.
