ObjectiveTo compare the functioning time, duration, cervical vascular blood flow and adverse effects of different concentrations of ropivacaine mesylate in performing stellate ganglion block (SGB) under Doppler ultrasound. MethodsA total of 240 patients (grade Ⅰ or Ⅱ classified by American Society of Anesthesiologists) aged between 23 and 62 years old ready to undergo SGB between January and April 2013 were chosen for our research. They were randomly divided into two groups with 120 patients in each. Group A and B received unilateral SGB with 7 mL of 0.239% and 0.596% ropivacaine mesylate respectively. Successful SGB was verified by Horner syndrome. The functioning time, duration, hemodynamic changes, cervical vascular blood flow and adverse effects were recorded and compared. ResultsHorner syndrome was observed in all patients. There was no significant difference in functioning time between the two groups (P>0.05). The duration of functioning was significantly longer in group B than that in group A (P<0.05). No significant difference was found in hemodynamic changes after SGB (P>0.05). No adverse effects were found in both groups. The blood flow of the vertebral artery and the internal carotid artery before the injection and 10 minutes after the injection were not significantly diferent (P>0.05). ConclusionSGB can be induced with 0.239% and 0.596% ropivacaine mesylate. We suggest using 0.596% ropivacaine mesylate by ultrasound-guiding because of the significantly longer functioning duration.
ObjectiveTo explore the relation between ultrasound images of endometriosis and its clinical symptoms. MethodsChoosing clinical data of 300 patients with endometriosis pathologically diagnosed between January 2009 and January 2014, we retrospectively analyzed ultrasound images and clinical symptoms, using Chisquare test for statistical analysis, and the index P<0.05 was statistically significant. ResultsIn patients with big endometriosis' nidus, the menstrual quantity increased, menstrual cycle prolonged, the incidence of abnormally vaginal bleeding was high (χ2=11.749, P=0.001; χ2=4.847, P=0.028; χ2=5.686, P=0.017). In patients whose endometriosis were located in posterior uterine wall, the menstrual quantity increased, and the incidence of abnormally vaginal bleeding was high (χ2=5.188, P=0.023; χ2=49.691, P<0.001). The size of endometriosis' nidus had nothing to do with dysmenorrhea, constipation and frequent micturition (P>0.05). The position of endometriosis' nidus had nothing to do with menostaxis, dysmenorrhea, constipation and frequent micturition (P>0.05). ConclusionThe size of endometriosis' nidus has a connection with the clinical symptoms of menorrhea, menostaxis and abnormally vaginal bleeding; the position of endometriosis' nidus has a connection with the clinical symptoms of menorrhea and abnormally vaginal bleeding. The results of ultrasonography should be combined with clinical symptoms in diagnosing endometriosis, avoiding missed-diagnosis and misdiagnosis.
ObjectiveTo comparatively analyze the image features of tumorous acute pancreatitis (T-AP) and non-tumorous acute pancreatitis (NT-AP). MethodsSixteen cases of histopathologically proven pancreatic tumors inducing acute pancreatitis and 30 cases of non-tumorous acute pancreatitis were collected, and studied their CT and MRI features. ResultsThere were 16 cases (100%) with focal nodules or masses in T-AP group and none in NT-AP group. The average innerdiameter of main pancreatic ducts in T-AP group was (9.6±6.8) mm, in which 14 cases (87.5%) were dilated. And the average innerdiameter of main pancreatic ducts in NT-AP group was (2.9±0.9) mm, in which 7 cases (23.3%) were dilated. The cases of sinistral portal hypertension (SPH), accompanying cholelithiasis and lymphadenosis between the two groups were 10 (62.5%), 3 (18.8%), 14 (87.5%), and 1 (3.4%), 25 (83.3%), 30 (100%), respectively. The occurrence of manifestation of focal nodules or masses, dilated main pancreatic ducts, SPH, and accompanying cholelithiasis were significantly different (P=0.000) between T-AP and NT-AP groups. While, the differences in enhancement pattern and the occurrence of lymphadenosis between the two groups were not significant (P > 0.05). ConclusionThe image features of T-AP are various. The application of CT and MRI could provide effective diagnostic guidelines for patients with T-AP.
Severe hallux valgus, a triplanar foot deformity significantly impairing patients’ quality of life, has witnessed progressive advancements in surgical management. This article systematically reviews the therapeutic progress through literature analysis, encompassing modifications of conventional surgical procedures and applications of novel techniques and innovative biomaterials. A critical analysis and discussion of these technological advancements and future developmental directions are presented to provide valuable insights and references for clinical management of severe hallux valgus.
ObjectiveTo summarize the individualized diagnosis and treatment experience in a patient with primary pancreatic diffuse large B-cell lymphoma.MethodsBy muti-disciplinary term (MDT) model, a patient with primary pancreatic diffuse large B-cell lymphoma admitted in the People’s Hospital of Chishui in Dec. 2016 was discussed. The diagnosis, perioperative period management, and operation scheme were carried out by the MDT.ResultsThe patient’s general condition was good. After multidisciplinary discussion in the Department of Radiology, Oncology, Interventional, and Hepatobiliary and Pancreatic Surgery, the patient was considered to have surgical indications. After thorough communication with the patient and family, the patient was selected for surgical resection. The whole operation lasted for 5 hours, and the intraoperative blood loss was about 300 mL. The operation was successfully completed and no complications such as pancreatic fistula occurred after operation. Liquid drainage tube was drawn out at 10 days after opertion, and pancreatic tube stent and T tube were retained. The patient discharged on 13 days after surgery. Subsequently, the patient underwent adjuvant chemotherapy. At present, the patient has been followed up for 1 year, no signs of tumor recurrence and metastasis, and continued follow-up.ConclusionsPrimary pancreatic diffuse large B-cell lymphoma is rare and has a poor prognosis. The main treatment is mutli-mode treatment based on surgical resection combined with chemotherapy.