Objective To evaluate the clinical application of the fistulography of multi-slice spiral CT(MSCT)in the diagnosis of anal fistula.Methods A total of 28 patients who were verified operatively of fistula in ano underwent preoperative fistulography of MSCT.The multi-planar reformation(MPR)and surface shadow display(SSD)images were generated and analyzed retrorespectively.Results There were 8 cases with perianal abscess and 20 cases with anal fistula in 28 patients.Complex fistula was diagnosed in 16 cases,and simple inter-sphincteric fistula was found in 4 cases;the inner orificiums of anal fistulas were revealed accurately with MPR images in 18 cases.Conclusion The fistulography of MSCT is valuable for preoperative assessment of anal fistula,in particular for investigation of the inner orificiums of anal fistulas with MPR.

Adult ; Balloon Occlusion ; instrumentation ; Cardiac Catheterization ; instrumentation ; Ductus Arteriosus, Patent ; surgery ; Female ; Humans ; Ligation ; instrumentation ; Recurrence

Female ; Humans ; Middle Aged ; Sarcoma, Myeloid ; Tonsillar Neoplasms

Abstract: Objective　To investigate the distribution and drug resistance characteristics of pathogenic bacteria in patients with neutropenic acute leukemia (AL) and bloodstream infections (BSI). Methods　The clinical data of 258 neutropenic acute leukemia patients with bloodstream infections, who admitted to Shengjing Hospital of China Medical University from January 2016 to December 2021, were collected and analyzed for pathogenic bacteria and drug resistance. Results A total of 268 strains of pathogenic bacteria were isolated from 258 patients, including 180 strains of gram-negative bacteria (67.16%), 61 strains of gram-positive bacteria (22.76%), and 27 strains of fungi (10.07%). Gram-negative bacteria were mainly Klebsiella pneumoniae (53/268, 19.78%), Escherichia coli (49/268, 18.28%) and Pseudomonas aeruginosa (41/268, 15.30%). Gram-positive bacteria were mainly coagulase negative Staphylococcus (31/268, 11.57%) and Staphylococcus aureus(17/268, 6.34%). The main fungi were Candida tropicalis (25/268, 9.33%). Escherichia coli (33/268, 12.31%) was the most common pathogen isolated from acute myeloid leukemia (AML), followed by Pseudomonas aeruginosa (25/268, 9.33%), coagulase-negative Staphylococcus (18/268, 6.72%) and Candida tropicalis (18/268, 6.72%). Klebsiella pneumoniae (35/268, 13.06%) was the most common pathogen isolated from acute lymphoblastic leukemia (ALL),followed by Pseudomonas aeruginosa (15/268, 5.60%) and Escherichia coli (14/268, 5.22%). The resistance of Gram-negative bacteria to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, meropenem, ertapenem, amikacin, cefoxitin, amoxicillin/clavulanic acid was low. Gram-positive bacteria were sensitive to linezolid and vancomycin. Candida was sensitive to flucytosine, amphotericin B and itraconazole. Conclusions　In patients with granulosa after AL chemotherapy combined with BSI, the pathogenic bacteria isolated from AML are diverse, and the pathogenic bacteria isolated from ALL are mainly gram-negative bacteria. Pathogenic bacteria have different degrees of drug resistance to commonly used antibacterial drugs, so it is important to strengthen the monitoring of the distribution of pathogenic bacteria and the change of drug resistance and rational use of antibacterial drugs to minimize the death of patients.

Histocytochemistry ; methods ; Humans ; Pathology, Clinical ; methods ; Specimen Handling ; methods ; Staining and Labeling ; methods

Objective To analyze the clinical features of rectal and perianal inflammatory myofibroblastic tumor and evaluate its diagnosis and treatment.Method Clinicopathological data of 3 cases diagnosed as inflammatory myofibroblastic tumor from January,2005 to June,2011 were retrospectively reviewed.Results Inflammatory myofibroblastic tumor presents as infiltrative growth mass with rich vascularization on CT or MRI,and is difficult to distinguish from hemangioma and other rectal tumors.Preoperative biopsy usually fails to ascertain the entity of mass,and pathological examination of the whole resected specimen with immunohistochemical staining is needed to make final diagnosis.All 3 cases underwent sphincter preserving surgery.One case received a second radical operation 16 months after primary resection because of local recurrence.All patients are followed up to now,with a survival time of 67 months,55 months,and 35 months respectively.Conclusions Rectal and perianal inflammatory myofibroblastic tumor is difficult to diagnose on preoperative imaging examinations or biopsy.Immunohistochemical staining is needed to make final diagnosis.Sphincter preserving surgery with complete tumor removal could achieve long term survival.

Objective To investigate the clinical value of intraoperative ultrasound guided precise positioning and enucleation of the functional islet cell tumor.Methods The clinical data of 20 patients with functional islet cell tumor who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2005 to December 2011 were retrospectively analyzed.The method of precise positioning,surgical approach and prognosis of the patients were reviewed.Results The accurate rates of computed tomography (CT),magnetic resonance imaging (MRI) and transabdominal B ultrasound in detecting the position of the functional islet cell tumors were 12/18,2/6 and 7/13,respectively,and the diameters of the tumors were (1.7 ±0.8)cm,(1.3 ±0.2)cm and (1.9 ±0.9)cm,respectively.The accurate rates of arterial stimulation venous sampling and pancreatic perfusion CT imaging were 100％,and the diameters of the tumor detected were (0.7 ± 0.3) cm and (0.9 ± 0.4) cm.The accurate rate of intraoperative B ultrasound examination was 14/14,and the diameter of the tumor was (1.5 ± 0.6)cm.Routine surgery was carried out on 6 patients,and 2 patients were complicated with grade C pancreatic fistula,and 1 was complicated with grade A pancreatic fistula.Fourteen patients received precise enucleation of islet cell tumor,and 4 patients were complicated with grade A pancreatic fistula.Twenty patients were followed up.The general condition of the patients was good till April 2012,and no death,tumor recurrence and metastasis were detected.Conclusions Combination of pre-and intraoperative imaging positioning could precisely locate functional islet cell tumor.If the distance between the tumor and main pancreatic duct is above 3 mm,precise enucleation of the islet cell tumor should be considered.

Objective To determine the conditioning regimen suitable for mice allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods Twelve BALB/c mice were randomly divided into 2 equal groups to undergo X-ray irradiation by linear accelerator at the dose of 7.0 Gy (pure X-ray group) or 60Co source irradiation at the dose of 7.0 Gy (pure γ-ray group).Thirty mice were randomly divided into 2 equal groups to undergo X-ray irradiation and then infusion of bone marrow from donor mice via caudal vein (X-ray + transplantation group) or γ-ray and then infusion of bone marrow via caudal vein (γ-ray + transplahtation group).3,5,7,10,15,20,and 30 d later peripheral blood samples were collected to calculate the number of white blood cells (WBCs) and detect the chimeric rates of lymphocytes by flow cytometry.5,10,and 20 d after irradiation 15 mice were killed with their lung,liver,small intestine,spleen,and femurs taken out to undergo pathological examination.Results The survival rates during the period 5-15 days of the γ-ray + transplantation group were all significantly higher than those of the X-ray + transplantation group.The pathological changes of organs of the X-ray +transplantation group were all more severe than those of the γ-ray + transplantation group.Since the fifth day after transplantation cells originating from the donor began to appear in the peripheral blood.The chimeric rate of the γ-ray + transplantation group 10 days after transplantation was (95.53± 2.57) %.The chimeric rates 5,10,and 20 days after transplantation of the γ-ray + transplantation group were all significantly higher than those of the X-ray + transplantation group (t = 15.263,3.256,P < 0.05).The WBC count of both irradiation groups decreased to the lowest level 5 d later and began to increase 10 days after transplantation and the WBC counts of the γ-ray + transplantation group 10 and 20 days aftertransplantation were both significantly higher than those of the X-ray + transplantation group (t = 3.624,6.695 ,P < 0.05).The chimeric rats of the peripheral lymphocytes 10 and 20 days after transplantation of the γ-ray + transplantation group were both significantly higher than those of the X-ray + transplantation group (t = 12.317,8.295,P < 0.05).The homogeneity rate of transplantation of the γ-ray +transplantation group was better than that of the X-ray + transplantation group.Conclusions As a conditioning regimen in allogeneic hematopoietic stem cell transplantation γ-ray irradiation causes milder injury and accelerated reconstitution of hematopoiesis and immunity,in comparison with X-ray irradiation.

Objective To investigate the molecular mechanism of osteoclast differentiation induced by staphylococcal lipoteichoic acid (LTA-sa). Methods Raw264.7 cells were treated with LTA-sa in a concentration of 200 ng/mL for 0, 5, 10, 20, 40, 60 min and 0, 1, 2, 3 days respectively, and the proteins in signaling pathways associated with osteoclast differentiation were measured with western blot. In addition, Raw264.7 cells were treated with different concentrations of LTA-sa (100, 200 and 400 ng/mL) and PBS for 0, 1, 2, 3 days, the expression of TNF-α, IL-1α and IL-6 was detected with Enzyme linked immunosorbent assay (ELISA). Results (1)Western blot showed that, under stimulation of LTA-sa, IκB-α decreased at 5 min and 10 min, while the phosphorylation of nuclear factor κB increased at 10 min . In addition , NFATc1 increased in 2 and 3 days gradually. The above results were statistically analyzed, and the difference was significant in statistics (P < 0.001). (2)ELISA showed that the expression of IL-6 increased in 2 and 3 days along with the increasing concentration and prolonging stimulation time of LTA-sa. Data were statistically analyzed, the difference was significant in statistics (P < 0.001). Conclusion LTA-sa promotes osteoclast differentiation through the NF-κB signaling pathway and the secretion of IL-6.

Objective To investigate the feasibility of using low Kv,low iodine contrast Agent concentration (dual low)CT scan techniques in Coronary CTA (CCTA).Methods Seventy-six patients undergoing CCTA were divided into Group A and Group B , randomly.Group A (38 patients)was the dual-low group,which was scanned with tube voltage of 100 kVp,and injected with iso-osmolarity contrast agent visipaque 270 (270 mg I/mL),with iterative reconstruction technique (ASIR 40%).Group B (38 pa-tients)was scanned with 120 kVp,and low osmolarity contrast agent omnipaque 350 (350 mg I/mL)and FBP reconstruction,The images are assessed double-blindly by two experienced radiologists.Five ROIs were placed onto the ascending root of aorta (AO), left main artery(LM),left anterior descending (LAD),left circumflex artery(LCX),right coronary artery (RCA),and the image qualities are evaluated objectively using CT values,noise,signal noise ratio (SNR),contrast noise ratio (CNR),and compared sta-tistically using Paired t-test.The radiation dosages,such as CTDIvol,DLP and ED were also recorded and compared with Paired t-test.Results CTDIvol,DLP and ED of Group A (dual low)decreased 35.7%,38.6% and 38.6% respectively compared with Group B,the iodine intake decreased 22.9%.While the image qualities of the two groups were not significantly different,all images are good enough for diagnosis,with Group A slightly better than Group B in radiologists’scores.Conclusion Voltage 100 kVp, combined with low contrast agent concentration of 270 mg I/mL can fully satisfy the diagnostics need in CCTA,and significantly lower both the radiation dosage and iodine intake.