Objective To evaluate the value of 3-D reconstruction in multi-detector spiral CT urography (MDCTU) for diagnosing upper urinary tract diseases (UUTDs) by means of both diagnostic sensitivity and ROC curve. Methods A total of 41 patients with UUTD were collected. All of them took MDCTU as well as reconstructions including MPR, MIP and VR. Compared with golden standards, the diagnostic value of MDCTU, MPR, MIP and VR were evaluated using both diagnostic sensitivity and ROC curve. Results a) A total of 49 upper urinary tract lesions were detected in those 41 patients; b) For UUTD, the localization diagnostic sensitivities of MPR, MIP, and VR were 48/49 (98.0%), 27/49 (53.2%), and 19/49 (38.8%), respectively; while their qualitative diagnostic sensitivities were 47/49 (95.9%), 17/49 (34.7%), and 13/49 (26.5%), respectively; the differences between MPR and the others were significantly (Plt;0.05); c) For distinguishing benign from malignant lesions, the Az value (area under ROC curve) of MPR, MIP, and VR were 0.998, 0.736 and 0.669, respectively; the differences between MPR and the others were significant (Plt;0.05); and d) MPR was completely the same as MDCTU in both diagnostic sensitivity and Az value. Conclusion The common 3-D reconstructions in MDCTU were different in value. MPR is highest in the diagnostic efficiency, which is similar to MDCTU, and is regarded as the basis of diagnosis; while MIP and VR are more stereo and intuitive. So it shows that the comprehensive application of CTU 3-D reconstructions has important value for diagnosing UUTD and distinguishing benign from malignant.
To improve the cavitation-to-tissue ratio (CTR) of cavitation imaging during the treatment with high-intensity focused ultrasound (HIFU), we proposed a pulse inversion based broadband subharmonic cavitation imaging method (PIBSHI). Due to the fact that the subharmonic signal is a unique nonlinear vibration characteristic of cavitation bubbles, we extracted the broadband subharmonic signal to get a high-CTR cavitation imaging. The simulation showed that the subharmonic signal produced by cavitating bubbles with different sizes varied, and the signal was stronger than other subharmonics when the bubbles’ resonant frequency was close to 1/2 subharmonic frequency. Further experiment results demonstrated that compared with the conventional B-mode images, broadband subharmonic cavitation imaging (BSHI) has improved the CTR by 5.7 dB, and the CTR was further improved by 3.4 dB when combined with pulse inversion (PI) technology. Moreover, when the bandwidth was set to 100%~140% of the 1/2 subharmonic frequency in PIBSHI, the CTR was the highest and the imaging showed the optimal quality. The study may have reference value for the development of precise cavitation imaging during HIFU treatment, and contribute to improve the safety of HIFU treatment.
ObjectiveTo review the association of gut microbiota and postoperative gastrointestinal dysfunction (GID) in patients after abdominal surgery and to provide a new idea for the pathogenesis, prevention, and treatment of postoperative GID in patients after abdominal surgery.MethodThe related and latest literatures were reviewed by searching the literatures on “intestinal flora” “gut microbiota” “intestinal microbial population” “brain-gut axis” “gastrointestinal function” “gastric paralysis” “intestinal paralysis” and “ileus” from January 1, 2000 to April 2, 2021 in Chinese and English databases.ResultsGut microbiota diversity was closely related to postoperative GID symptoms in patients after abdominal surgery. Gut microbiota regulated gastrointestinal motility and mucosal barrier function by metabolizing food to produce metabolites such as 5-hydroxytryptamine, melatonin, short-chain fatty acid, succinic acid, lactic acid, and so on.ConclusionsThe imbalance of gut microbiota is closely related to postoperative GID in patients after abdominal surgery. However, the relevant bacterial metabolites that have been found are limited at present, and the relevant mechanism needs to be further investigated.
Objective To investigate the effects of preoperative calcaneal traction versus plaster splint fixation on the prognosis of unstable ankle fractures. Methods Patients with unstable ankle fractures admitted to the first People’s Hospital of Shuangliu District / West China (Airport) Hospital Sichuan University between April 2021 and March 2023 were selected. The enrolled patients were randomly divided into the experimental group (calcaneal traction fixation) and the control group (plaster splint) by using a random number table method. The preoperative waiting time, surgical duration, intraoperative blood loss, number of complications, fracture healing time, length of hospital stay, total hospitalization costs, and American Orthopaedic Foot and Ankle Society scores for the ankle joint were compared between the two groups. Results A total of 100 patients were included. Among them, there were 48 cases in the experimental group and 52 cases in the control group. There was no statistically significant difference between the two groups in terms of gender, age, and Denis-Weber typing (P>0.05). The patients were followed up for 12-26 months, with an average of (18.6±4.5) months. All ankle fractures clinically healed. The experimental group reported two cases of post-traumatic arthritis; the control group had one case of post-traumatic arthritis, one case of preoperative tension blisters with epidermal necrosis, and one case of superficial infection at the surgical incision postoperatively. The preoperative waiting time in the experimental group was significantly shorter than that of the control group [(7.35±3.23) vs. (10.04±5.34) days; P<0.05]. There was no statistically significant difference in the surgical duration, intraoperative blood loss, clinical fracture healing time, length of hospital stay, and total hospitalization costs between the two groups (P>0.05). Additionally, American Orthopaedic Foot and Ankle Society scores at postoperative months 1, 3, 6, 12, and at the last follow-up showed no significant differences between the two groups (P>0.05). Conclusions In conclusion, for unstable ankle fractures, there is no significant difference in clinical efficacy between preoperative calcaneal traction and plaster splint fixation. Calcaneal traction may reduce preoperative waiting time and lower the risk of soft tissue complications.
Objective To explore the effect factors on the related measurement guidelines of renal area and renal cortex thickness by measurement of CT/MRI radiography in vivo kidney in adults. Methods Thickness of renal cortex (TC), cortical area (CA), parenchymal area (PA), as well as cortical faction (CF, cortical/parenchymal area) of 164 cases (106 cases with enhanced CT abdomen and 58 cases with MRI abdomen scanning) without renal disease was calculated bilaterally. All data were analyzed by SPSS 11.5 (the mean of two groups and multi-groups was compared by t test and analysis of variance, respectively).Results ① In CT scan, the mean value and 95% confidence interval of TC，CA，PA and CF were 0.62 (0.44 to 0.80) cm, 7.2 (4.1 to 10.2) cm2, 18.2 (10.7 to 25.7) cm2, 39.3 (30.3 to 48.3) % on the left, and 0.63 (0.43 to 0.83) cm, 7.3 (4 to 11) cm2, 18.1 (11 to 25.3) cm2, 39.9 (32 to 48) % on the right, respectively. Likewise, in MRI, those were 0.58 (0.33 to 0.83) cm, 7.5 (3.5 to 11.3) cm2, 14.8 (8.5 to 21.1) cm2, 50.2 (32.8 to 67.6) % on the left, and 0.55 (0.31 to 0.79) cm, 7.3 (4.4 to 10.3) cm2, 15.6 (10.1 to 21.1) cm2, 47.3 (30 to 65) % on the right. ② There was a significant difference in the value of TC, CA, PA between different gender and age groups, and were decreased with the age increaseing. ③ Most of the values measured by MRI were less than those by CT. Conclusions The study suggests that the values of TC, CA, PA and CF can well represent the renal size and function, and may offer a practical and significant normal standard in the radiological diagnosis.
Objective To compare the blood glucose level and associated hypoglycemia risks by using insulin Glargine or human NPH both combined with Glipizide GITS in the treatment of type 2 diabetic patients. Methods Fifty-six cases with inadequate glycemia control by sulfonylurea and/or other oral agents were randomized in two groups (3∶1). In the Glarine group, 42 patients were given Clipizide GITS 5 mg every morning and injection of Glargine at bedtime daily, while 14 patients in the NPH group were given Clipizide GITS 5 mg every morning and injection of NPH at bedtime daily. The dosage of insulin was adjusted by FBG level, seeking a target of FBG＜6.7 mmol/L, and the treatment lasted for 12 weeks. The blood glucose level and incidence of hypoglycemia were observed. The daily dosages of Glargine and NPH were recorded to analyze their relations between FBG and BMI at the beginning of the trial. Results Mean of FBG and daily glucose profile were similar in the 2 groups, but the incidence of hypoglycemia in the Glargine group was significantly lower than that in the NPH group (3 cases in the Glargine group, 7.1%, 5 cases in the NPH group, 35.7%, χ2=7.0, P =0.008). Mean daily dosages of glargine at the end point were closely related to FBG and BMI at baseline. Conclusions Bedtime injection of Glargine combined with Glipizide GITs can achieve target blood glucose control and is safer than NPH. This simple “one pill-one injection” regimen may help us achieve recommended blood glucose control targets with better patients’ compliance.
目的 探讨小肠扭转的CT影像学表现及多层螺旋CT的诊断价值。 方法 回顾性分析2006年2月－2011年8月14例经手术证实肠扭转患者的临床及影像资料。 结果 14例小肠扭转患者中有9例出现“U形征”，13例有肠管和血管的“漩涡征”，4例有“鸟喙征”，2例可见“靶环征”，1例可见空回肠“转位征”。 结论 肠管及血管的“漩涡征”是诊断小肠扭转的特异性征象，“鸟喙征”、“靶环征”等其他CT征象为小肠扭转的正确诊断提供可靠依据。多层螺旋CT扫描及三维重组对小肠扭转的诊断具有重要价值。