ObjectiveTo evaluate the dynamic changes of blood flow and blood pressure of acute hindlimb ischemia of rats by laser Doppler flowmetry (LDF) and laser Doppler perfusion imaging (LDPI). MethodsThe acute hindlimb ischemia model of rats was established by resection of rats femoral arteries of left hindlimb. The blood flow and blood pressure between operated and nonoperated hindlimbs were examined by LDF on 2, 7, 14, 28, and 49 d after operation. And the blood flow was evaluated by LDPI on 7 d after operation. ResultsAll rats survived after operation and no hindlimb necrosis occurred. The mean score was 2 on 14 d after operation and 1 on 49 d after operation. The ratio of blood flow between operated and nonoperated hindlimbs on 2 d after operation significantly increased from 1 to 1.31±0.439 (P=0.021). The ratio of blood flow on 7 d (0.82±0.538) and 14 d (0.93±0.294) after operation was significantly lower than that on 2 d after operation (P=0.032 and P=0.019), although the difference between the two former was not significant (P=0.502). Furthermore, the ratio of blood flow on 28 d after operation reached the bottom (0.41±1.970), which was obviously lower than that on 2, 7, and 14 d after operation (P=0.004, P=0.007, and P=0.006). The blood flow of operated hindlimbs recovered approximately the value before operation (0.98±0.093), which was significantly lower than that on 2 d (P=0.010), higher than that on 28 d (P=0.005), but not different from that on 7 d and 14 d after operation (P=0.126 and P=0.382). The ratio of blood pressure between operated and nonoperated hindlimbs on 2 d after operation significantly increased from 1 to 0.47±0.375 (P=0.031). The ratio of blood pressure decreased on 7 d after operation (0.44±0.118), which was not different from that on 2 d after operation (P=0.203). Furthermore, the ratio of blood pressure on 14 d after operation reached the bottom (0.35±0.115), which was obviously lower than that on 2 d and 7 d after operation (P=0.001 and P=0.036). On 28 d after operation, the ratio of blood pressure increased (0.54±0.146), which was significantly higher than that on 14 d after operation (P=0.008), while not different from that on 2 d (P=0.493) and 7 d after operation (P=0.551). The ratio of blood pressure recovered approximately the value before operation (0.97±0.094), which was significantly higher than that on 2, 7, 14, and 28 d (P=0.013, P=0.021, P=0.002, and P=0.031). ConclusionAcute hindlimb ischemia model of rats can be established by resection of rats femoral arteries of left hindlimb and the most serious stage of hindlimb ischemia is on 14-28 d after operation. LDF and LDPI are of importance for monitoring the dynamic changes of rats hindlimb ischemia after operation.
Objective To evaluate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in obstructive jaundice. Methods Forty eight consecutive patients with obstructive jaundice were examined by MRCP, all results were testified during and /or after operation. Results Different causes of obstruction had their own characteristic manifestations. Level of obstruction was accurate in 100%, the accuracy in distinguishing obstructive causes was 93.8%. Conclusion MRCP is quite effective, safe and reliable in diagnosis of obstructive jaundice.
ObjectiveTo observe the multimodal imaging characteristics of combined hamatoma of the retina and retinal pigment epithelium (CHRRPE).MethodsA retrospective case study. From January 2013 to December 2017, 6 CHRRPE patients (6 eyes) diagnosed in Department of Ophthalmology, Sun Yat-sen Memorial Hospital were included in the study. There were 4 males and 2 females, with the mean age of 12.0±8.10 years. There were 5 eyes with BCVA ≤0.1, 1 eye with BCVA＞1.0. Corneal fluoroscopy showed 1 eye with an external oblique 15°, and the remaining eye had no abnormalities in the anterior segment. All eyes underwent fundus color photography, FAF, FFA, ICGA, OCT and color Doppler flow imaging (CDFI). The multimodal imaging characteristics were observed.ResultsAll the affected eyes CHRRPE were located in the posterior pole and showed mild elevation. Most of the retinal neuroepithelial layers had different degrees of hyperplasia, vascular tortuosity and retinal folds. Of the 6 eyes, 4 eyes (66.7%) involving the macula and optic disc, only 2 eyes (33.3%) involving the macula. OCT showed that the structure of the neuroepithelial layer was unclear and the signal intensity was uneven; it involved 2 eyes of the whole retina (33.3%) and only 4 eyes of the neuroepithelial layer (66.7%). FFA and ICGA showed that the choroidal background fluorescence of the early lesions was weakened, and the lesions showed slightly weak fluorescence; the late telangiectasia fluorescein was obviously leaked, and the lesions were stained with fluorescence. FAF mainly appears as weak autofluorescence with a small amount of strong autofluorescence. CDFI has no characteristic performance.ConclusionsCHRRPE is mainly a membrane-like hyperplasia without angiogenesis, involving the retinal neuroepithelial layer, and may also involve the entire retina. OCT is dominated by strong reflection; AF, FFA and ICGA are mainly weak fluorescence.
Lung cancer management is complex and requires a multi-disciplinary approach to provide comprehensive care. Interventional pulmonology (IP) is an evolving field that utilizes minimally invasive modalities for the initial diagnosis and staging of suspected lung cancers. Endobronchial ultrasound guided sampling of mediastinal lymph nodes for staging and detection of driver mutations is instrumental for prognosis and treatment of early and later stage lung cancers. Advances in navigational bronchoscopy allow for histological sampling of suspicious peripheral lesions with minimal complication rates, as well as assisting with fiducial marker placements for stereotactic radiation therapy. Furthermore, IP can also offer palliation for inoperable cancers and those with late stage diseases. As the trend towards early lung cancer detection with low dose computed tomography is developing, it is paramount for the pulmonary physician with expertise in lung nodule management, minimally invasive sampling and staging to integrate into the paradigm of multi-specialty care.
ObjectiveTo evaluate the spectral domain optical coherence tomography (SD-OCT) characteristics of polypoidal choroidal vasculopathy (PCV) and its correlation with the visual acuity after photodynamic therapy (PDT) combined with intravitreal ranibizumab. MethodsTwenty-six eyes of 26 patients with PCV diagnosed by indocyanine green angiography (ICGA) were enrolled in this study. All the patients were examined for best corrected visual acuity (BCVA), slit lamp microscope, SD-OCT, fundus fluorescein angiography (FFA) and ICGA before and 1, 3 months after treatment. The mean baseline BCVA was (31.46±16.87) letters, mean central retinal thickness (CRT) was (581.19±309.05) μm, and mean subfoveal choroidal thickness (SFCT) was (248.92±95.45) μm. Patients were divided into 2 groups according to the final visual improvement after 6 month of treatment: GR or sensitive Group (17 eyes) and PR or non-sensitive Group (9 eyes). GR group included 12 males and 5 females, with a mean age of (65.24±7.03) years, a mean CRT of (619.06±335.07) μm and a mean SFCT of (271.24±106.61) μm. There were 4 eyes with subretinal hemorrhage (SRH), 2 eyes with interface retinal fluid (IRF), 13 eyes with subretinal fluids (SRF) and 15 eyes with pigment epithelial detachment (PED). PR group included 8 males and 1female, with a mean age of (64.00±7.02) years, a mean CRT of (509.67±255.21) μm and a mean SFCT of (271.24±106.61) μm. There were 6 eyes with subretinal hemorrhage (SRH), 5 eyes with interface retinal fluid (IRF), 6 eyes with subretinal fluids (SRF) and 8 eyes with pigment epithelial detachment (PED). The difference of sex, age, CRT and SFCT between these two groups was not significant (P>0.05). The relationship of baseline SD-OCT and post-treatment BCVA was analyzed. ResultsOn 1, 2, 3, 6 months after treatment, the BCVA were (38.46±19.81), (40.04±20.80), (42.96±21.63), (43.77±20.91) letters respectively. On 6 months after treatment, the mean CRT in GR and PR group were (360.71±276.54), (341.44±193.68) μm respectively (P>0.05). 64.71% (11/17) eyes in GR group and 22.22% (2/9) eyes in PR group had a SFCT thicker than 263μm. The difference was statistical significant between two groups [odds ratio (OR):0.052, 95% confidence interval (CI):0.005-0.533; P=0.013]. Logistic regression analysis showed that existence of IRF (OR=9.375, 95% CI: 1.299-67.645; P=0.026) or SRH (OR=6.500, 95% CI: 1.094-38.633; P=0.040) at baseline was negative prognostic factor to treatment. ConclusionThick SFCT is a protective factor, however, existence of IRF or SRH at baseline is negative prognostic factor of final visual improvement.
In order to protect the integrity and function of the digestive system, duodenum-preserving total pancreatic head resection is becoming the surgical method which was chosen by more and more doctors for benign lesions or low-grade malignant tumors of the pancreatic head. With the development of minimally invasive concepts and techniques, laparoscopic technology has brought unique advantages to this surgery. In this paper, a series of problems such as the development process and indications of laparoscopic duodenum-preserving total pancreatic head resection were discussed, and the core techniques of surgery and how to reduce the occurrence of complications were emphasized. The aim is to improve the therapeutic effect and quality of life of patients through reasonable surgical methods and treatment strategies.
Objective To investigate the correlation of red blood cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) with total imaging load of cerebral small vessel disease (CSVD), and the clinical diagnostic value of RDW, NLR and their combined indicators for high load of CSVD imaging. Methods The medical records of CSVD patients hospitalized in the Department of Neurology of Baotou Central Hospital between October 2018 and October 2022 were retrospective collected. The total imaging load of CSVD was obtained by evaluating the cranial MRI and divided into a low load group and a high load group. The general clinical data, past medical history, and blood biochemical indicators were compared between the two groups. The correlation analysis method was used to analyze the relationship between the relevant indicators and the total imaging load. Logistic regression analysis was used to analyze the risk factors of the total imaging load of CSVD. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of the detection indicators for clinical diagnosis. Results A total of 320 patients were included. Among them, there were 201 cases (62.81%) in the low load imaging group and 119 cases (37.19%) in the high load imaging group. Excepted for age, gender, history of hypertension, RDW, and NLR (P<0.05), there was no statistically significant difference in the comparison of other indicators between the two groups (P>0.05). Spearman correlation analysis showed that RDW (r=0.445, P<0.001) and NLR (r=0.309, P<0.001) were positively correlated with the total imaging load of CSVD. The results of multivariate logistic regression analysis showed that age, male gender, RDW, and NLR were risk factors for high imaging load of CSVD. The areas under the ROC curve of RDW, NLR, and their combined indicators were 0.733, 0.644, and 0.792, respectively.Conclusions In patients with CSVD, the levels of RDW and NLR are related to the total imaging load of CSVD, which are independent risk factors for high imaging load of CSVD. The levels of RDW and NLR have clinical diagnostic value in predicting CSVD high load.
The portable light-weight magnetic resonance imaging system can be deployed in special occasions such as Intensive Care Unit (ICU) and ambulances, making it possible to implement bedside monitoring imaging systems, mobile stroke units and magnetic resonance platforms in remote areas. Compared with medium and high field imaging systems, ultra-low-field magnetic resonance imaging equipment utilizes light-weight permanent magnets, which are compact and easy to move. However, the image quality is highly susceptible to external electromagnetic interference without a shielded room and there are still many key technical problems in hardware design to be solved. In this paper, the system hardware design and environmental electromagnetic interference elimination algorithm were studied. Consequently, some research results were obtained and a prototype of portable shielding-free 50 mT magnetic resonance imaging system was built. The light-weight magnet and its uniformity, coil system and noise elimination algorithm and human brain imaging were verified. Finally, high-quality images of the healthy human brain were obtained. The results of this study would provide reference for the development and application of ultra-low-field magnetic resonance imaging technology.
ObjectiveTo explore the diagnostic value of “Four-Step Procedure” of laparoscopic exploration in patients with peritoneal metastasis of gastric cancer.MethodsWe retrospectively collected the data of 409 gastric adenocarcinoma patients from July 2016 to August 2020 who underwent “Four-Step Procedure” of laparoscopic exploration in West China Hospital. The descriptive case series study was conducted to analyze the outcome of laparoscopic exploration combined with CY (cytology test), stepwise treatment plans, and the rates of CY1 and P1 (peritoneal metastasis) among cT3–4 patients during different periods. SPSS 22.0 software was used to conduct the univariate and multivariate logistic regression to analyze the high risk factors associated with P1 and (or) CY1.ResultsA total of 409 gastric adenocarcinoma patients who underwent laparoscopic exploration were enrolled in our study. Among them, 65 patients were confirmed to be P1 and (or) CY1. Stratified analysis by cT and cN staging showed that there were 7 (7.4%) and 55 (27.9%) patients with peritoneal metastasis in cT3 staging and cT4 staging, respectively. After laparoscopic exploration, 168 patients received laparoscopic gastrectomy, 35 patients received laparotomy, 143 patients received neo-adjuvant chemotherapy, and 63 patients received conversion therapy. The bar chart showed an ascending tendency in the diagnosis rate of P1 over time among cT3–4 patients. Multivariate logistic regression analysis showed that ascites was an independent risk factor of CY1 and (or) P1 (P<0.001). Additionally, the postoperative complication rate was 2.9% in the patients who merely underwent laparoscopic exploration, including 4 patients with pulmonary infection and 2 patients with urinary retention.Conclusions“Four-Step Procedure” of laparoscopic exploration is reliable and feasible for gastric cancer. “Four-Step Procedure” of laparoscopic exploration has high diagnostic value for peritoneal metastasis of gastric cancer. Our study shows that most of peritoneal metastasis distribute in cT3 and cT4 patients. For these patients, laparoscopic exploration should be recommended to identify if peritoneal metastasis exists and avoid unnecessary laparotomy.
ObjectiveTo construct a map of cerebral cortex thickness in Idiopathic Generalized Epilepsy (IGE) diagnosed at the first visit, using T1-weighted brain magnetic resonance imaging and advanced image analysis software. MethodsHigh-resolution three-dimensional T1 images were obtained from 27 IGE patients diagnosed at the first visit and 29 normal controls in Shouguang People's Hospital from January 1, 2022 to December 31, 2021. The location recognition calculation system of the Freesurfer software was used to calculate the values of cortical thickness in each brain region, and the cortical thickness values were transformed into a brain atlas using the image analysis software. A differential brain atlas was generated using the two-sample t-test to analyze the difference in cortical thickness between IGE patients and normal controls. Paired t-test was used for within-group comparison to explore changes of cortical thickness laterality. ResultsIn the IGE brain atlas, the brain regions with higher cortical thickness were the right left temporal pole, the right left entorhinal cortex, the head of the right anterior cingulate gyrus, the right and left insular lobe, the right and left middle temporal gyrus, the right inferior temporal gyrus, the head of the left anterior cingulate gyrus, the left tail of the anterior cingulate gyrus, the left inferior temporal gyrus, the left and right fusiform gyrus, and the left frontal pole. The areas with lower cortical thickness were the right and left paracalcaric gyrus, the right and left cuneiform lobe, the left and right lingual gyrus, the left and right posterior central gyrus, the left lateral occipital gyrus, and the right and left superior parietal gyrus. The distribution of cortical thickness of the IGE group was comparable to the cortical thickness atlas of the normal control. Compared with normal control, the areas with changes of cortical thickness in the IGE group were bilateral superior frontal gyrus, bilateral posterior central gyrus, bilateral anterior central gyri, bilateral lingual gyri, left cuneiform lobe, bilateral entorhinal cortex and temporal pole. The brain areas with laterality of cortical thickness between hemispheres in the IGE group were the tail of anterior cingulate gyrus, cuneiform lobe, inferior parietal gyrus, lateral occipital gyrus, posterior central gyrus, head of anterior cingulate gyrus, and superior marginal gyrus. Compared with normal control, the IGE group has decreased number of brain regions with laterality of cortical thickness. ConclusionThe present study revealed the distribution and laterality of cerebral cortical thickness map in early idiopathic generalized epilepsy, which provides imaging structural basis for brain research in the future.