ObjectiveTo discuss the CT characteristics of combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC), and analyze the reasons for its misdiagnosis. MethodWe retrospectively analyzed the CT data of 7 patients diagnosed to have combined hepatocellular carcinoma and cholangiocarcinoma by postoperative pathological analysis between January 2009 and February 2015. We analyzed such characteristics as location, shape, density, enhanced features, surrounding invasion, mediastinal lymph node metastasis, cirrhosis and pyoperitoneum of the disease. ResultsThere were 7 tumors among the 7 patients. Plain scan showed slightly lower density nodules or masses. After the enhancement of arterial phase, 5 tumors showed obvious inhomogeneous enhancement but 2 mild marginal enhancement. During the portal venous phase and the delay stage, the regional degree of tumor foci was significantly decreased, but some regions sustained annular or nodular and patchy enhancement. Among the 7 cases, the portal vein was invaded in 2, bile duct in 1, lymph node metastasis in 2, cirrhosis in 1, and peritoneal effusion in 1. Preoperative diagnosis was correct in only 2 cases and the other 5 cases were misdiagnosed by CT. ConclusionsThe cHCC-CC possesses some characteristic appearances on CT. Analyzing the characteristics carefully combining with symptom and cytological examination of hydrothorax can reduce the incidence of misdiagnosis.
ObjectiveTo analyze the effectiveness and problems existing in implementing acquired immune deficiency syndrome (AIDS) control and prevention in community health service centers, and to provide scientific evidence for promoting AIDS control and prevention. MethodsRelated information on AIDS control and prevention in community health service centers in a community in the whole year of 2013 was acquired. The effectiveness and problems existing in case management, laboratory testing and highly active antiretroviral therapy (HAART) based on the current community health service system were analyzed. ResultsBy the end of 2013, the rate of AIDS case management was from zero to 100%, the rate of CD4 T detection was from 76.60% (360/470) to 88.35% (508/575), and the rate of receiving highly active antiretroviral therapy among AIDS patients was from 81.40% (175/215) to 84.41% (287/340). But in the actual work on AIDS in community health service centers, there were still some common problems needing to be solved. ConclusionThe community level management mode of AIDS can promote the accuracy of AIDS patients' information, improve the rate of case management, the rate of CD4 T detection and HAART. It is suggested that the community level management mode of AIDS should be promoted in the cities where AIDS patients are concentrated.
ObjectiveTo discuss the diagnostic value of multi-slice spiral CT for bronchial mucoid impaction in early central-type carcinoma of lung. MethodsWe used multi-planar reformat, maximum intensity projection and minimum intensity projection to observe the characteristics of 15 patients with bronchial mucoid impaction in early central-type carcinoma of lung treated between March 2010 and October 2013. The characteristics included location, shape and enhanced performance of the tumor and the bronchial mucoid impaction. All the cases were confi rmed by operation or pathology. ResultsAmong the 15 cases, 12 were squamous cell carcinoma and 3 adenocarcinoma; 8 occurred on the right and 7 on the left. All the tumors showed equal density and were enhanced moderately. Bronchial mucoid impaction showed low density, no enhancement, accompanied bronchiectasis and occurred in bronchi which were far from the tumor, and there were 9 cases of strip, 5 of fabrication, and 1 of nodositas or cystic carcinoma. ConclusionThe location and shape of tumor and bronchial mucoid impaction are displayed clearly by multi-slice spiral CT and enhancement scanning can differentiate tumor from bronchial mucoid impaction. Multi-slice spiral CT has important diagnostic value in bronchial mucoid impaction of primary lung cancer in its early stage.
ObjectiveTo discuss the CT characteristics of pleural lung cancer, and analyze the reason for misdiagnosis. MethodsThe CT data of 8 patients with pleural lung cancer confirmed by postoperative pathology and treated in Renshou People's Hospital and Fist Affiliated Hospital of Chongqing Medical University between January 2010 and December 2013 were retrospectively analyzed. ResultsAmong the 8 cases of pleural lung cancer, 6 occurred on the left and 2 on the right; there were 3 nodular and 5 irregular masses; 6 had uniform density and 2 had irregular focus and relatively lower density; 4 had osteolytic destruction of adjacent ribs; 6 had pleural effusion; and 5 had mediastinal lymph nodes enlargement, in which 1 had multiple lymph node metastasis of left lung hilum, left supraclavicular region and left axillary. All the 8 cases were enhanced moderately. ConclusionPleural lung cancer has certain featured manifestations on CT. Analyzing the features carefully, considering clinical symptoms, and cytological examination of hydrothorax can reduce the incidence of misdiagnosis.
ObjectiveTo systematically review the clinical efficacy and safety of hyperbaric oxygen therapy as adjunctive treatment for diabetic foot ulcers. MethodsSuch databases as The Cochrane Library (Issue 1, 2014), PubMed, EMbase, CBM, VIP, CNKI and WanFang Data were searched up to January 2014 for randomized controlled trials (RCTs) about hyperbaric oxygen therapy as adjunctive treatment for diabetic foot ulcers. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsFourteen RCTs involving 910 patients were included. The results of meta-analysis showed that, hyperbaric oxygen therapy combined with routine therapy was superior to routine therapy alone regarding ulcer healing rates (RR=2.16, 95%CI 1.43 to 3.26, P=0.000 3), incidence of major amputation (RR=0.20, 95%CI 0.10 to 0.38, P < 0.000 01), reduction of ulcer area (MD=1.73, 95%CI 1.34 to 2.11, P < 0.000 01), and improvement of transcutaneous oxygen tension (MD=14.75, 95%CI 2.01 to 27.48, P=0.02). However, no significant difference was found between the two group in minor amputation rates (RR=0.70, 95%CI 0.24 to 2.11, P=0.53). In addition, neither relevant serious adverse reaction nor complications were reported when using hyperbaric oxygen therapy as adjunctive treatment. ConclusionCurrent evidence shows that hyperbaric oxygen therapy as adjunctive treatment could improve ulcer healing and reduce incidence of major amputation.
ObjectiveTo systematically review the efficacy and safety of probiotics for the treatment of Helicobacter pylori (H.pylori) infection in children. MethodsWe electronically searched The Cochrane Library, PubMed, EMbase, CNKI, VIP and WanFang Data databases to collect randomized controlled trials (RCTs) about probiotics for the treatment of H.pylori infection in children from inception to January 2015. The references of included studies and conference proceedings were manually searched for additional studies. Two reviewers independently screened literature, extracted data and assessed the risk of bias of include studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of twelve RCTs were included, involving 1 227 patients. The result of meta-analysis showed that the probiotics adjuvant therapy group was superior to the control group in H.pylori eradication rates (OR=2.23, 95%CI 1.66 to 2.99, P<0.000 01) and the incidence of adverse effect (OR=0.31, 95%CI 0.18 to 0.53, P<0.000 1). ConclusionCurrent evidence shows that probiotics adjuvant therapy may be a new effective and safe solution in the treatment of H.pylori infections in children. Due to the limited quality and quantity of the included studies, more higher quality studies are needed to verify the above conclusion.
ObjectiveTo study the clinical characteristics of elderly hemodialysis (HD) patients and discuss how to control their complications, in order to improve their quality of life and lower their mortality rate. MethodContrastive study and analysis were performed on the clinical data of 98 maintenance HD patients (between elderly and young HD patients) between January 2013 and January 2014. Complications, rate of hospitalization and mortality were analyzed during the follow-up of one year. ResultsThe ratio of hypertensive kidney disease and diabetic nephropathy, as primary disease of the elderly HD patients, gradually increased. More people chose to use semi-permanent jugular vein catheter for elderly HD patients. Compared with young HD patients, the levels of hemoglobin, albumin, serum creatinine, KT/v were lower in the elderly patients, and C-reactive protein was much higher (P<0.05). There was no significant difference in cholesterol, triglyceride, calcium, phosphorus, parathormone between the two groups (P>0.05). Dialysis-related hypotension and blocking of vascular access occurred more frequently in elderly HD patients. Hospitalization rate and mortality rate were higher in elderly HD patients (P<0.05). ConclusionsImproving nutritional status, keeping vascular access unobstructed for a long time and decreasing complications related to hemodialysis are helpful for elderly HD patients to enhance their quality of life and reduce the mortality rate.
The possibility of polyoxymethylene (POM) as heart valve leaflet material was investigated by comparing the hemocompatibility with that of 316L stainless steel and low-temperature isotropic pyrolytic carbon (LTIC). Surface hydrophobicity was characterized by water contact angle measurement.Platelet adhesion, APTT/PT/TT and hemolysis rate tests were applied for evaluating hemocompatibility. The results showed that POM was hydrophobic and had a low hemolytic rate, adhesion amount and activation degree of platelets on POM surface were less than 316L stainless steel, and was similar to LTIC. This research pointed out potential application of POM as heart valve leaflets.
ObjectiveTo observe expre with ssions of insulin receptor substrate 1(IRS-1) and ubiquitin-protein in skeletal muscle of non-obese rats with type 2 diabetes mellitus following gastric bypass operation (GBP), and to investigate possible mechanism of GBP in improving insulin resistance. MethodsMale GK rats were randomly divided into diabetic operation group (DO group), diabetic sham operation group (DSO group), and diabetic control group (DC group), 8 rats in each group; besides 8 male Wistar rats were served as normal control group (NC group). Fasting body weight (FBW), fasting plasma glucose (FPG), and fasting insulin (FINS) were measured respectively before operation and on week 1, 2, 4 and 8 after operation. Homeostasis model-insulin resistant (HOMA-IR) index was calculated respectively before operation and on week 8 after operation. The expressions of IRS-1 protein and ubiquitin-protein in skeletal muscle were detected by using Western blot method on week 8 after operation. Results① Compared with the preoperative levels, the FBWs on week 1, 2, and 4 after operation markedly decreased (P < 0.05), but it recovered to the preoperative level on week 8 after operation (P > 0.05) in the DO group; which in the DSO group decreased on week 1 after operation (P < 0.05) and then increased on week 4 after operation (P < 0.05); which in the DC group or the NC group increased continuously and had a significant difference on week 8 after operation (P < 0.05).② The FPGs in the DO, DSO and DC groups were significantly higher than those of the NC group before operation (P < 0.05), which in the DO group decreased from (9.10±0.98) mmoL/L before operation to (5.70±0.91) mmol/L on week 8 after operation (P < 0.05) and were significantly lower than those of the DSO group or the DC group on week 2, 4, and 8 after operation (P < 0.05); which in the DC group, DSO group and NC group had no obviously changes between before and after operations (P > 0.05). ③ The FINS had no significant differences among these four groups before operation (P > 0.05), which in the DO group obviously increased[(9.64±1.59) mU/L] on week 2 after operation (P < 0.05) and then obviously decreased[(6.58±1.05) mU/L] on week 8 after operation (P < 0.05) and significantly lower than those of the DSO group or the DC group on week 8 after operation (P < 0.05), while which had no significant difference between before and after operations in the DSO group, the DC group, or the NC group (P > 0.05). ④ The HOMA-IR index in the DO, DSO or DC group was significantly higher than that of the NC group before operation (P < 0.05), which in the DO group markedly decreased from 3.18±0.50 before operation to 1.96±0.63 on week 8 after operation (P < 0.05) and significantly lower than that of the DSO group or the DC group on week 8 after operation (P < 0.05), while which had no significant difference between before and after operations in the DSO group, the DC group, or the NC group (P > 0.05). ⑤ The expression of IRS-1 protein in the DO group was significantly higher than that in the DSO group (P < 0.05) or the DC group (P < 0.05) on week 8 after operation. While there was no significant difference between the DSO and the DC group after operation (P > 0.05). ⑥ Compared with the NC group, the expression of ubiquitin-protein was significantly increased in the DO group, the DSO group, or the DC group (P < 0.05). Compared with the DSO group or the DC group, the expression of ubiquitin-protein was significantly decreased in the DO group on week 8 after operation (P < 0.05), especially it was most obvious near the molecular weight of 180×103. While there was no significant difference between the DSO group and the DC group after operation (P > 0.05). ConclusionsExpression of IRS-1 protein in skeletal muscle insulin signaling pathway in type 2 diabetes mellitus rats following GBP is increased, it might be associated with decreasing ubiquitin-protein level in skeletal muscle, thus reduces the IRS-1 ubiquitin-degradation, increase insulin sensitivity, and improve insulin resistance of skeletal muscle.
ObjectiveTo investigate the accuracy of multi-slice spiral CT (MSCT) scan and image reconstruction technology for measuring morphological parameters of costal cartilages and to evaluate the volume of costal cartilages. MethodsBetween March and August 2013, 75 patients with congenital microtia and scheduled for auricle reconstruction were included in the study. Of 75 patients, there were 49 males and 26 females with a mean age of 8 years and 5 months (range, 5 years and 7 months to 32 years and 7 months) and a mean weight of 29.5 kg (range, 21-82 kg). A Philips Brilliance 64 MSCT machine was used to scan 1st-12th costal cartilages with the parameters based on the age and weight of the patients. All the data were transported to the workstation for reconstructing the image of the costal cartilages with the technique of maximum intensity projection (MIP) and volume rendering technique (VRT). Then the morphologies of costal cartilages were observed through the images on VRT; the width of the costal cartilaginous ends close to ribs (W) and the length of the total cartilage (L) were measured and compared with their counterparts (W' and L') after the costal cartilages were harvested during the processes of auricle reconstructions to analyze consistency between these two sets of data. ResultsThe morphologies of ribs and costal cartilages shown on VRT image got fine sharpness, verisimilitude, and stereoscopic impressions. A total of 192 costal cartilages were examined. The results showed that the widths of the costal cartilaginous ends close to ribs (W) was (9.69±1.67) mm, and W' was (9.73±1.64) mm, showing no significant difference between W and W' (t=-1.800, P=0.073), and interclass correlation coefficient (ICC) test showed Cronbach's α=0.993. The length of the total cartilage (L) was (83.03±23.86) mm, and L' was (81.83±16.43) mm, showing no significant difference between L and L' (t=1.367, P=0.173), and ICC test showed Cronbach's α=0.904. Linear-regression analysis showed L=1.28×L'-21.93 (R2=0.780, F=673.427, P=0.000). The results suggested there was a good consistency between these two sets of data. ConclusionScanning costal cartilages with appropriate parameters and reconstructing the cartilaginous image with MIP is an effective method to measure the width and length of costal cartilage and to estimate costal cartilage volume, which can provide accurate reference for plastic surgery together with reading the morphology from the image on VRT.