Objective To investigate the application of U100plus laser in treating incarcerated in gallbladder stones. Methods The clinical data of 52 patients accepted U100plus laser lithotripsy of gallbladder neck incarcerated were retrospective analyzed. Results All 52 patients were successful treated by surgery. Twelve patients with gallbladder wall edema, drainage tubes were used to prevent bile leakage after gallbladder surgery. After 2~4 d, the ultrasound examination showed that no abnormal drainage, and tube was removed. The mean operative time was 40 min. The mean intraoperative bleeding was 2 mL. Patients were able to get out of bed 1 day after surgery. The average length of hospital stay was 4 d. Pa-tients were followed up for 6 to 30 months, and no special discomfort, The ultrasonography showed no stone recurrence. Conclusion U100plus laser lithotripsy is a safe and effective method for treating incarcerated gallbladder stones.

Objective To compare the different doses of low-temperature plasma (LTP) on wound healing in BALB/c mice so as to discuss the effects of the optimal dose of low-temperature plasma dealing with wound in mice and the acting mechanism of wound healing.Methods Adoptatmospheric pressure plasma jet discharged by the dielectric barrier was used to treat mouse skin wound.According to the processing time, the wounds were divided into 10s, 20s, 30s, 40s and 50s experimental groups, while naturally healing wounds served as negative controls and the wounds dealt with recombinant human epidermal growth factor served as positive controls.We recorded the wound size every day, observed the histopathological changes, the expression level of type Ⅰ collagen by immunofluorescence, and analyzed the composition of low-temperature plasma jet.Results The wounds with plasma treatment time of 10s, 20s, 30s, and 40s showed significant daily improvement and almost complete closure at days 12, 10, 7, 13, respectively.However, the wounds with plasma treatment time of 50s remained unhealed atday 14.The wounds in positive control group all healed, and the wound healing effect in positive control group could be achieved in 30s group.HE staining and immunofluorescence staining assays showed the optimal result of epidermal cell regeneration, granulation tissue hyperplasia, and collagen deposition in histological aspect at day 7 in 30 s group.The low-temperature plasma jet contained highly reactive free radicals of nitrogen and oxygen, which play an important role in wound healing process.Conclusion Appropriate doses of cold plasma can accelerate wound healing whereas over-doses of plasma can suppress wound healing.The process of wound healing may be related to reactive oxygen and nitrogen species in LTP.

OBJECTIVE: To explore the clinical effect of ultrasound guided microwave ablation in the treatment 01 recurrent thyroid nodules. METHOD: Seventy-five cases of recurrent thyroid nodules were treated with ultrasound guided microwave ablation(MWA) under local anesthesia. All the patients underwent biopsy puncture, then the microwave ablation needle puncted in the center site of nodule with energy of 25-35 W, and the center tempera- ture could reach to 70-95 °C. RESULT: MWA were successfully performed in all the patients without significant com- plications. Temporary hoarseness occurred in 5 cases and dispeared after 1-3 weeks, choking water occurred in 2 patients and recovered 3-5 days later. Ultrasound examination showed that the bloodstream of thyroid nodules disappeared in all the patients, and the nodules diminuted with varying degrees at 3-month and at 6-month follow- up Serum FT4 and TSH did not change significantly. CONCLUSION Ultrasound guided MWA could be effective in the treatment of recurrent thyroid nodule with minimal invasive technology.
Anesthesia, Local ; Catheter Ablation ; Humans ; Microwaves ; Recurrence ; Thyroid Nodule ; surgery ; Treatment Outcome ; Ultrasonics

Objective: To investigate the clinicopathological features and treatment strategy of pseudomyxoma peritonei (PMP) of ex-tra-appendiceal origin. Methods: Clinical data of 34 patients diagnosed with PMP of extra-appendiceal origin who were treated by cy-toreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in the Aerospace Center Hospital from September 2011 to February 2019 were retrospectively analyzed. Clinical and imaging features were summarized and the Log-rank test was used for survival analysis. Results: The clinical manifestations of the 34 patients with PMP of extra-appendiceal origin were mainly abdomi-nal distension (58.8%) and abdominal pelvic mass (52.9%), which are very similar to those of appendiceal PMP. The incidence of main complications after CRS and HIPEC was 14.7%. During the follow-up period of a median of 12 months (range 1-46 months), 9 patients died, and the 1-and 3-year overall survival rates were 69.6% and 53.5%, respectively. In the univariate analysis, peritoneal cancer in-dex (PCI)>20, no HIPEC, and non-radical surgery were significant risk factors for poor prognosis, while gender, age, origin, and patho-logical type did not show significant correlations. Conclusions: The clinical features of PMP of extra-appendiceal origin are not differ-ent to those of PMP originating from the appendix. It is difficult to ascertain the primary lesion before the operation; however, regard-less of the origin, CRS combined with HIPEC is always a safe and effective treatment choice.

Objective To investigate the related factors and preventive measures of delayed gastric emptying after operation for esophageal and cardiac carcinoma.Methods A total of 45 patients with delayed gastric emptying after operation for esophageal and cardiac carcinoma were selected as observation group,and 45 patients without delayed gastric emptying after operation for esophageal and cardiac carcinoma were selected as control group.Differences in the relevant factors were compared between the two groups.Results Single factor analysis showed that older age,high body mass index,short time education,malnutrition,poor mental state,rural residence,surgical incision,blood loss,long operation time,postoperative analgesia pump application,and the large amount of fluid volume were related risks of delayed gastric emptying (P ＜ 0.05).The Logistic regression analysis showed that older age (OR =4.15,95 ％ CI:1.89 ～ 26.30),bad psychological reaction (OR =3.96,95％ CI:1.38 ～ 25.38),long operation time (OR =3.40,95％ CI:1.11 ～ 20.28) and malnutrition (OR =3.02,95％ CI:1.09 ～ 19.35) were independent factors of delayed gastric emptying.Conclusion Delayed gastric emptying is one of the common complications after operation for esophageal and cardiac carcinoma,and the influencing factors are complex.

Objective To investigate the related factors and preventive measures of delayed gastric emptying after operation for esophageal and cardiac carcinoma.Methods A total of 45 patients with delayed gastric emptying after operation for esophageal and cardiac carcinoma were selected as observation group,and 45 patients without delayed gastric emptying after operation for esophageal and cardiac carcinoma were selected as control group.Differences in the relevant factors were compared between the two groups.Results Single factor analysis showed that older age,high body mass index,short time education,malnutrition,poor mental state,rural residence,surgical incision,blood loss,long operation time,postoperative analgesia pump application,and the large amount of fluid volume were related risks of delayed gastric emptying (P ＜ 0.05).The Logistic regression analysis showed that older age (OR =4.15,95 ％ CI:1.89 ～ 26.30),bad psychological reaction (OR =3.96,95％ CI:1.38 ～ 25.38),long operation time (OR =3.40,95％ CI:1.11 ～ 20.28) and malnutrition (OR =3.02,95％ CI:1.09 ～ 19.35) were independent factors of delayed gastric emptying.Conclusion Delayed gastric emptying is one of the common complications after operation for esophageal and cardiac carcinoma,and the influencing factors are complex.

Objective To explore the value of deep learning(DL)models semi-automatic training system for automatic optimization of clinical image quality control of transthoracic echocardiography(TTE).Methods Totally 1 250 TTE videos from 402 patients were retrospectively collected,including 490 apical four chamber(A4C),310 parasternal long axis view of left ventricle(PLAX)and 450 parasternal short axis view of great vessel(PSAXGv).The videos were divided into development set(245 A4C,155 PLAX,225 PSAXGV),semi-automated training set(98 A4C,62 PLAX,90 PSAXGV)and test set(147 A4C,93 PLAX,135 PSAXGV)at the ratio of 5:2:3.Based on development set and semi-automatic training set,DL model of quality control was semi-automatically iteratively optimized,and a semi-automatic training system was constructed,then the efficacy of DL models for recognizing TTE views and assessing imaging quality of TTE were verified in test set.Results After optimization,the overall accuracy,precision,recall,and F1 score of DL models for recognizing TTE views in test set improved from 97.33％,97.26％,97.26％and 97.26％to 99.73％,99.65％,99.77％and 99.71％,respectively,while the overall accuracy for assessing A4C,PLAX and PSAXGV TTE as standard views in test set improved from 89.12％,83.87％and 90.37％to 93.20％,90.32％and 93.33％,respectively.Conclusion The developed DL models semi-automatic training system could improve the efficiency of clinical imaging quality control of TTE and increase iteration speed.

OBJECTIVETo analyze the clinical features of patients with gallbladder cancer from 17 hospitals in 5 Northwestern provinces (autonomous region) of China from 2009 to 2013.

METHODSA total of 2 379 cases with gallbladder cancer in 17 tertiary hospitals from 5 Northwestern provinces of China from January 2009 to December 2013 were reviewed retrospectively. The clinical data was collected by standardized "Questionnaire for Clinical Survey of Gallbladder Cancer in Northwestern Area of China". χ² test was used to analyze the data.

RESULTS(1) Gallbladder cancer from 17 hospitals accounted for 1.6%-6.8% of all bile tract diseases from 2009 to 2013 in Northwestern China, average was 2.7%. Gallbladder cancer accounted for 0.4%-0.9% of abdominal surgery, average was 0.7%. (2) The incidence of gallbladder cancer was higher in the aged females, the ration of female to male was 1.0 to 2.1. The average age of gallbladder cancer was (64 ± 11) years. The occupation of patients was mainly farmers (χ² = 147.10, P < 0.01). (3) 57.2% of the gallbladder cancers were associated with gallstones. (4) The main pathological patterns of gallbladder cancer were moderate and poor differentiated adenocarcinoma, showing an aggressive malignancy. TNM stage IV accounted for 55.1% of all cases, which was associated with the poor prognosis. (5) The curative resection rate was 30.4%.

CONCLUSIONSGallbladder cancer is common in the aged females and mainly at advanced stage. The screening and follow-up of high-risk groups with ultrasound and other methods regularly could increase the early diagnosis rate of gallbladder cancer, aggressive surgical resection combined with other comprehensive treatment could improve the prognosis of patients.

Adenocarcinoma ; epidemiology ; pathology ; Aged ; China ; epidemiology ; Female ; Gallbladder Neoplasms ; epidemiology ; pathology ; Gallstones ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

【Objective】 To observe the inactivation effect of a new low-temperature plasma air disinfector on microorganisms in the natural environment and artificial contaminated environment so as to further determine the minimum effective processing parameters. 【Methods】 First， in 0.5 m³ of super clean workbench and 1.05 m³ airtight organic glass cavity in the body， the new low-temperature plasma air disinfector developed was used to inactivate the natural bacteria in the air under different parameters. Then in 1.05 m³ airtight organic glass cavity in the body， the new low-temperature plasma air disinfector was used to treat the Staphylococcus aureus and Escherichia coli under the condition of artificial bacteria spraying. Last， the plate counting method was used to evaluate the inactivation effect of the disinfector on natural bacteria and artificial bacteria in the air. 【Results】 For the low-temperature plasma air disinfector in 0.5 m³ and 1.05 m³ confined space， the lowest effective treatment parameters for inactivated natural bacteria were 13 kV， 5 min or 12 kV， 10 min. For the low-temperature plasma air disinfection machine in 13 kV discharge voltage treatment of different time， compared with before treatment， the killing rate of Escherichia coli and Staphylococcus aureus increased significantly after treatment for 20 min （P<0.000 1）. Both could meet the requirements of disinfection specifications ［100%， （99.98±0.01）%≥99.90%］. 【Conclusion】 The inactivation of natural bacteria and artificial bacteria by the new low-temperature plasma air disinfector has reached the qualified standard of disinfection stipulated in Technical Specifications for Disinfection.