Transcranial magneto-acoustic electrical stimulation (TMAES) is a novel method of brain nerve regulation and research, which uses induction current generated by the coupling of ultrasound and magnetic field to regulate neural electrical activity in different brain regions. As the second special envoy of nerve signal, calcium plays a key role in nerve signal transmission. In order to investigate the effect of TMAES on prefrontal cortex electrical activity, 15 mice were divided into control group, ultrasound stimulation (TUS) group and TMAES group. The TMAES group received 2.6 W/cm2 and 0.3 T of magnetic induction intensity, the TUS group received only ultrasound stimulation, and the control group received no ultrasound and magnetic field for one week. The calcium ion concentration in the prefrontal cortex of mice was recorded in real time by optical fiber photometric detection technology. The new object recognition experiment was conducted to compare the behavioral differences and the time-frequency distribution of calcium signal in each group. The results showed that the mean value of calcium transient signal in the TMAES group was (4.84 ± 0.11)% within 10 s after the stimulation, which was higher than that in the TUS group (4.40 ± 0.10)% and the control group (4.22 ± 0.08)%, and the waveform of calcium transient signal was slower, suggesting that calcium metabolism was faster. The main energy band of the TMAES group was 0?20 Hz, that of the TUS group was 0?12 Hz and that of the control group was 0?8 Hz. The cognitive index was 0.71 in the TMAES group, 0.63 in the TUS group, and 0.58 in the control group, indicating that both ultrasonic and magneto-acoustic stimulation could improve the cognitive ability of mice, but the effect of the TMAES group was better than that of the TUS group. These results suggest that TMAES can change the calcium homeostasis of prefrontal cortex nerve clusters, regulate the discharge activity of prefrontal nerve clusters, and promote cognitive function. The results of this study provide data support and reference for further exploration of the deep neural mechanism of TMAES.
Objective To investigate the clinical application of the right grstroepiploic artery (RGEA) in offpump coronary artery bypass grafting (OPCAB). Methods We retrospectively analyzed the clinical data of the 38 patients who underwent RGEA grafts for OPCAB between December 2008 and July 2009 in the First Affiliated Hospital of Nanjing Medical University. According to the difference of grafts, 76 patients undergoing OPCAB were divided into two groups. In the RGEA group, there were 38 patients including 36 males and 2 females with an age of 65.87±6.29 years. For the patients in this group, OPCAB was carried out with RGEA and other routine conduits as grafts. The control group had 38 patients including 35 males and 3 females with an age of 66.68±6.24 years. They underwent OPCAB with left internal mammary artery (LIMA), radial artery (RA), or saphenous vein (SV) as grafts. The intraoperative and postoperative clinical data for patients in both groups were analyzed and compared. Results All operations were carried out without serious complications like reoperation for bleeding, functional delayed gastric emptying, or severe infection, and no operative death occurred. Compared with the control group, operative time in the RGEA group was longer (295.53±45.16 min vs. 262.50±42.44 min,P=0.001), the number of anastomotic stomas [CM(159mm]was less (4.71±0.56 vs. 5.29±0.92, P=0.002), and less intraoperative plasma was consumed (194.74±186.30 ml vs. 565.79±382.70 ml, P=0.000). The 24 h drainage loss (394.71±205.36 ml vs. 536.32±258.85 ml, P=0.008), the blood cell consumption (1.67±1.48 U vs. 2.81±2.48 U, P=0.010) and the postoperative hospital stay (12.47±3.20 d vs. 15.47±9.31 d, P=0.035) were significantly lower in the RGEA group compared with those in the control group. Meanwhile, the time of postoperative mechanical ventilation time was longer in the RGEA group than that in the control group (1 398.82±1 349.94 min vs. 985.39±170.30 min, P=0.036). Seventytwo patients were followed up for a period from 9 to 17 months with 4 cases lost. No myocardial ischemia occurred in both groups of patients. Conclusion RGEA is an effective arterial conduit for OPCAB. It needs high technology and takes long operative time to apply RGEA in OPCAB.
Objective To introduce the total mesorectal excision (TME)under the laparoscope and with the ultrosonic scalpel. Methods Under the laparoscope and with the ultrosonic scalpel, total mesorectal excision in 3 patients was performed. In operation, alone the parietal layer of pelvic fascia and inside the automatic nerve trunk, the mesorectum was excised with the ultrasonic scalpel. Results Three patients got final recovery, no damage to the viscera in operation occurred. Average hemorrhage amount was about 100ml. Intestinal function recovered within 24 hours, average in hospital time was 10.3 days. After 4 months, 3 patients got good living quality without recurrence and metastasis.Conclusion TME under the laparoscope is a new progress of less damageable operation. Compared with the traditional open laparotomy,it has some advantage. But it requires high technology and expensive equipments, and the case is still very limited in use.
Objective To explore the practicability and safety of ultrasonic bone curette in the laminoplasty of spinal canal after resection of intraspinal tumors. Methods The clinical data of 17 patients with thoracolumbar intraspinal tumors treated with ultrasonic bone curette after resection of intraspinal tumors between December 2015 and April 2017 were retrospectively analyzed. All patients were male, aged 42-73 years with an average of 57.4 years. The disease duration was 2-47 months with an average of 21.1 months. Among them, there were 4 cases of thoracic intrathoracic tumors (T10 in 1, T12 in 3) and 13 cases of lumbar intrathoracic tumors (L1 in 5, L2 in 4, L3 in 2, and L4 in 2). Postoperative pathological diagnosis showed that 8 cases were schwannoma, 4 cases were meningioma, 2 cases were neurofibroma, 2 cases were dermoid cyst, and 1 case was ependymoma. Spinal nerve function was evaluated preoperatively according to Frankel classification criteria, with 2 cases of grade B, 7 cases of grade C, and 8 cases of grade D. During the operation, the time of single segmental vertebral canal posterior wall incision, the overall operation time, intraoperative blood loss, intraoperative dural injury, and cerebrospinal fluid leakage, spinal cord and nerve root injury were recorded. At 3-6 months after operation, the tumor and bone healing were observed according to MRI and CT three-dimensional reconstruction, and the spinal nerve function was evaluated by Frankel classification. Results The time of ultrasonic osteotomy for the posterior wall of a single segmental vertebral canal was 3.4-5.7 minutes, with an average of 4.1 minutes. The overall operation time was 135-182 minutes, with an average of 157.3 minutes. The intraoperative blood loss was 300-500 mL, with an average of 342.6 mL. There was no accidental dural injury, and cerebrospinal fluid leakage, nerve root injury, or spinal cord injury. The incision healed by first intention after operation. All the 17 patients were followed up 9-18 months, with an average of 12.7 months. MRI examination showed no tumor recurrence, and CT three-dimensional reconstruction showed good bone healing in all patients. During the follow-up, there was no loosening or rupture of the internal fixator and there was no re-compression of the spinal cord. At last follow-up, according to Frankel classification, there were 1 case as grade B, 5 cases as grade C, 7 cases as grade D, and 4 cases as grade E. Conclusion The application of ultrasonic bone curette in laminoplasty of spinal canal after resection of intraspinal tumors can preserve the integrity of the bone ligament structure of posterior column, maintain the volume of vertebral canal, and has high safety, practicability, and good postoperative effectiveness.
In order to investigate the mechanism of blood supply to the delayed separated skin flap and the time and criteria for its transfer, 5 smallsized Banna pigs were selected to produce 14 skin flaps. In the experimental group the skin flap on one side was made from the middle of the back having an extrathin steel sheet intervened between the flap and the soft tissue of the back whereas the flap on the opposite side without a steel sheet intervened was served as the selfcontrol. The skin flaps were examined 3,7,10 and 20 days after the operation and 3,7 and 10 days after transfer, respectively, by (1) gross observation; (2) ultrasonic Doppler; (3) superficial skin temperature measurement and; (4) histomorphological examination. In the experimentalgroup the survival rate of the flap was 100 percent whereas in the control group all of the flaps had necrosis from 30 to 50 percent after the flap being transfered. In the experimental group, the echo sound from the arterial blood flow from ultrasonic Doppler was heard at the pedicle 7 days after the operation, and as time elapsed, the echo sound spread distally, whereas in the controls no echo sound could be heard over the skin flap. There was significant difference statistically between the experimental and control groups in the temperature of the flaps while the flaps were being transferred (P lt; 0.01). The external diameters of the blood vessels in the central area of the skin flap were larger in the experimental group, 0.8 to l.2mm in comparison to 0.4mm.
ObjectiveTo investigate the ultrasonic changes of hepatic veins and splenic veins during various immune stages with different CD4+T lymphocyte count. MethodsFifty AIDS/HIV patients with chronic viral hepatitis treated between January 2010 and October 2013 were designated as the case group, and another 50 patients with simple chronic viral hepatitis were regarded as the controls. For patients in the case group, we observed their ultrasonic changes of hepatic and splenic veins during various immune stages with different CD4+T lymphocyte count. The results of observation and clinical laboratory analysis were compared. ResultsAbnormal ultrasonic changes were detected in the liver in various immune stages based on the CD4+T lymphocyte count, and the main manifestations of these changes included unclear portal and splenic vein distal direction, wide diameter, slowed blood flow velocity, and disappearance of fluctuations of blood flow spectrum; and unclear hepatic vein distal direction, low and three-phase, and negative blood flow spectrum with the disappearance of windows were also detected. There were no statistical differences between the case group and the control group when the CD4+T cell count was over 300/mm3, and a few indexes were significantly different when the CD4+T cell count was between 100 and 200/mm3. However, the differences of almost all indexes were significant when the CD4+T cell count was below 100/mm3. ConclusionPatients with HIV/AIDS combined with chronic viral hepatitis have ultrasonographic abnormalities of intrahepatic and splenic veins, which is more obvious as the CD4+T cell count declines. Overall consideration of intrahepatic vein and splenic vein ultrasonic indicators helps clinical assessment of disease development in patients with HIV/AIDS combined with chronic viral hepatitis.
ObjectiveTo explore the value of ultrasound real-time tissue elastography in the differential diagnosis between benign and malignant breast lesions.Methods A total of 131 cases of patients with breast lesions who underwent ultrasound examination in the People’s Hospital of Guangan City between December 2010 and December 2015 were enrolled as the research object. The patients took conventional color Doppler ultrasound diagnosis firstly, and then took ultrasound real-time tissue elastography diagnosis. The lesions were scored with improved 5-scoring system respectively. By the strain ratio measure method equipped with the ultrasonic machine, strain ratio of the lesion was calculated, with 3.08 as the cut-off pont. The results were campared with the pathologic diagnosis.ResultsThere were 182 breast lumps in the 131 patients. The conventional ultrasound examination detected 128 benign lesions and 54 malignant lesions. By ultrasound real-time tissue elastography examination, there were 121 benign tumors and 61 malignant tumors. For the benign tumors, the elasticity imaging score was 1.74±0.81, and the elastic strain rate ratio was 1.83±1.22; for the malignant tumors, the elasticity imaging score was 4.45±0.59, and the elastic strain rate ratio was 8.68±5.58. The 182 breast lumps were all removed by surgical resection, and the pathologic examination showed there were 121 benign lesions and 61 malignant lesions. The accuracy, sensitivity and specificity of conventional ultrasonic diagnosis of breast malignant lesions was 76.4%, 59.0% and 85.1%, respectively; while the indexes of ultrasound real-time tissue elastography diagnosis of breast malignant lesions was 96.7%, 95.1% and 97.5%, respectively, and the differences were statistically significant (P<0.05).ConclusionReal-time tissue elastography is helpful in the differential diagnosis between malignant and benign breast lesions.
In recent years, the incidence of thyroid diseases has increased significantly and ultrasound examination is the first choice for the diagnosis of thyroid diseases. At the same time, the level of medical image analysis based on deep learning has been rapidly improved. Ultrasonic image analysis has made a series of milestone breakthroughs, and deep learning algorithms have shown strong performance in the field of medical image segmentation and classification. This article first elaborates on the application of deep learning algorithms in thyroid ultrasound image segmentation, feature extraction, and classification differentiation. Secondly, it summarizes the algorithms for deep learning processing multimodal ultrasound images. Finally, it points out the problems in thyroid ultrasound image diagnosis at the current stage and looks forward to future development directions. This study can promote the application of deep learning in clinical ultrasound image diagnosis of thyroid, and provide reference for doctors to diagnose thyroid disease.
Objective To investigate the effect of ultrasonic bone curette in anterior cervical spine surgery. MethodsA clinical data of 63 patients with cervical spondylosis who were admitted between September 2019 and June 2021 and met the selection criteria was retrospectively analyzed. Among them, 32 cases were operated with conventional instruments (group A) and 31 cases with ultrasonic bone curette (group B). There was no significant difference between the two groups (P>0.05) in gender, age, surgical procedure, surgical segment and number of occupied cervical space, disease type and duration, comorbidities, and preoperative Japanese Orthopaedic Association (JOA) score, cervical dysfunction index (NDI), and pain visual analogue scale (VAS) score. The operation time, intraoperative bleeding, postoperative drainage, postoperative hospital stay, and the occurrence of postoperative complications were recorded in both groups. Before operation and at 1, 3, and 6 months after operation, the JOA score and NDI were used to evaluate the function and the postoperative JOA improvement rate was calculated, and VAS score was used to evaluate the pain improvement. The anteroposterior and lateral cervical X-ray films were taken at 1, 3, and 6 months after operation to observe whether there was any significant loosening and displacement of internal fixators. ResultsCompared with group A, group B had shorter operation time and postoperative hospital stay, less intraoperative bleeding and postoperative drainage, and the differences were significant (P<0.05). All incisions healed by first intention in the two groups, and postoperative complications occurred in 5 cases (15.6%) in group A and 2 cases (6.5%) in group B, showing no significant difference (P>0.05). All patients were followed up 6-12 months (mean, 7.9 months). The JOA score and improvement rate gradually increased in groups A and B after operation, while the VAS score and NDI gradually decreased. There was no significant difference in VAS score between 3 months and 1 month in group B (P>0.05), and there were significant differences between the other time points of each indicator in the two groups (P<0.05). At 1, 3, and 6 months after operation, the JOA score and improvement rate in group B were better than those in group A (P<0.05). X-ray films examination showed that there was no screw loosening or titanium plate displacement in the two groups after operation, and the intervertebral cage or titanium mesh significantly sank. ConclusionCompared with traditional instruments, the use of ultrasonic bone curette assisted osteotomy in anterior cervical spine surgery has the advantages of shorter operation time, less intraoperative bleeding, less postoperative drainage, and shorter hospital stay.
ObjectivesTo investigate the ultrasound findings of the synovial hemangioma of knee (SHK) and to evaluate its value in clinical diagnosis.MethodsThe ultrasonographic manifestations and clinical data of 10 patients with SHK confirmed by surgery and pathology were retrospectively analyzed and compared with MRI findings, surgery and pathological results.ResultsSeven cases of SHK (6 cases of diffuse type, 1 case of limited type) were assessed by ultrasound, including 1 case of vascular origin, 1 case of supraorbital sac origin, 1 case with pigmented villonodular synovitis, 1 case with thrombosis, 2 cases accompanied with bone erosion and osteophyte formation, and 3 cases with joint cavity effusion. Ultrasonic findings of SHK were as followed: 7 cases of SHK were manifestate as diffuse mass with unclear boundary, irregular shape and uneven echo mass; 5 cases had mixed-echo mass with reticular structures inside, an increased volume in erect position and positive CDFI compression test; 1 case had heterogeneous hypoechoic mass with a nodular appearance and the positive compression test; 1 case as poorly-demarcated, irregular shape, heterogeneous hyperechoic mass without obvious blood flow signals under the compression test. There were no characteristic ultrasonic findings from other 3 cases of SHK.ConclusionsDiffuse SHKs have characteristic ultrasonograms. SHKs with localized and significant synovial hyperplasia have no specific ultrasonic manifestation and are easily misdiagnosed. Ultrasound is convenient, noninvasive and inexpensive. It can accurately evaluate the involvement of knee joint capsule and surrounding soft tissues. It can be used as the first line diagnostic modality for routine scanning of SHKs.