ObjectiveTo study the effect of hyperbaric oxygenation (HBO) treatment on post-stoke depression (PSD) and neurological functional rehabilitation.Methods60 patients with PSD were randomly divided into two groups, treatment group and control group. Patients in the treatment group were given HBO treatment in addition to the regular treatment. Changes of scores of Hamilton depression (HAMD), Chinese stroke scale (CSS), and activity of daily living (ADL) before and after treatment in two groups were observed and evaluated.ResultsAfter 1 month treatment scores of HAMD, CSS, and ADL in the treatment group got obviously better results than before treatment (P<0.01). While scores in the control group had no significant difference(P>0.05).Conclusions It is suggested that HBO may improve the depressive symptom and neurological functional rehabilitation in PSD patients.

Objective To compare the efficacy of radical and quasi-radical hepatectomy for the treatment of end-stage hepatic alveolar echinococcosis(HAE)with involvement of major blood vessels and viscera.Methods The clinical data of 41 patients with end-stage HAE who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2002 to January 2010.All patients were divided into radical hepatectomy group (13 patients)and quasi-radical hepatectomy group(28 patients)according to whether blood vessels were reconstructed and repaired.The operation time,blood loss,length of hospital stay,recurrence and metastasis of HAE,pleural effusion,ascites,biliary complications and death between the 2 groups were compared.All data were analyzed by using the t test or chi-square test.Results The volume of blood loss,length of hospital stay,number of patients with recurrence and metastasis of HAE,obstructive jaundice and number of dead patients were(326 ±115)ml,(22 ± 18)days,0,0,and 0 in the radical hepatectomy group,and were(24 ± 20)ml,(15 ± 12)days,10,10 and 10 in the quasi-radical hepatectomy group,there were significant differences between the 2 groups(t =13.41,1.47;x2 = 4.36,4.36,4.36,P ＜ 0.05).The operation time,number of patients with pleural effusion and ascites,bile leakage,cholangitis and number of patients died perioperatively were(407 ± 146)minutes,4,0,1 and 1 in the radical hepatectomy group,and(263 ± 93)minutes,2,2,2 and 1 in the quasi-radical hepatectomy group,there were no significant differences between the 2 groups(t = 3.81;x2 = 2.30,0.04,0.34,0.04,P ＞ 0.05).Conclusions Radical hepatectomy should be the first choice when construction of infringed vessels can be achieved.Quasi-radical hepatectomy has lower operation risks for avoiding important vessels injury.

Objective To explore the CT and MR imaging findings of acinic cell carcinoma (ACC)in salivary gland and enhance the diagnosis of this rare disease.Methods The CT and MR imaging characteristics of 20 patients (7 males and 13 females,median age 44 years old) with pathologically proved ACC were retrospectively reviewed.CT and MR images were evaluated in relation to the following: location,size,morphology,margin,CT density/MR signal intensity and enhancement pattern.Results Twelve lesions were located in parotid gland,two lesions in maxillary Sinus,and one lesion in submandibular,parapharyngeal,infratemporal fossa,buccal,nasal cavity,and hard palate respectively.The size of lesions were 0.7～5.8 cm.Sixteen lesions less than 3 cm in size demonstrated round or oval round masses with well defined margin.Four lesions more than 3 cm in size demonstrated irregular masses with unclear margin.Among them,bony destruction of the wall of the maxillary sinus was noted in 3 cases,and the preauricular skin was invaded in 1 case.The densities (signal intensity) were homogeneous in 6 cases and heterogeneous in 14 cases.Lesions were slightly low density in 11 case and isodensity in 3 cases on CT plain scan.Lesions were homogeneous isointense in 2 cases and heterogeneous isointense in 4 cases on T1WI,heterogeneous hyperintense in all cases on T2WI.On post contrast images,lesions demonstrated remarkable enhancement in 14 cases,moderate enhancement in 2 cases and mild enhancement in 3 cases.Conclusions The imaging characteristic of ACC were nonspecific.CT and MR could accurately detect the extent of tumor involvement and was helpful to provide more comprehensive information for the strategy of clinic therapy.

Objective To evaluate the CT and MR imaging findings of salivary duct carcinoma (SDC) in order to enhance the understanding of this rare disease.Methods A retrospective analysis of CT and MRI images was performed in 20 patients (14 males and 6 females,median age 56 years old) with pathologically proved SDC.CT and MR images were evaluated with respect to the following feature factors:location,size,morphology,margin,CT density/ MR signal intensity and enhancement pattern.Results Thirteen lesions were located in parotid gland,4 lesions in submandibular gland,1 lesion in sublingual gland and 2 lesions in the buccal spaces.The maximum diameter of SDC ranged from 1.5 to 7.0 cm,mean (3.5 ±0.9) cm.Five cases demonstrated round or oval round masses with well-defined margin,15 cases demonstrated irregular masses with ill-defined edge.Among them,the peritumoral fat tissues were infiltrated in 7 cases,the preauricular skin were invaded in 3 cases,the jaw muscles were invaded in 2 cases and the parapharyngeal space,pterygoid muscle,retromandibular vein was invaded in 1 case respectively.Lesions were homogeneous in 4 cases and heterogeneous in 16 cases.Seven lesions showed varied calcifications.Lesions were homogeneous iso-intense in 1 case and heterogeneous iso-intense in 2 cases on T1WI,heterogeneous hyperintense in all cases on T2WI.On post contrast images,lesions demonstrated remarkable enhancement in 17 cases,moderate enhancement in 3 cases.Enlarged cervical lymph nodes were found in 12 cases.Conclusions SDC has nonspecific imaging characteristics.CT and MR examinations can accurately demonstrate the extent of tumor involvement and are helpful to provide more comprehensive information for SDC management.

Objective To evaluate the clinical pathway (CP) for treatment of hepatic cystic echinococcosis.Methods Data were retrospectively obtained from hospitalized patients with hepatic cystic echinococcosis (CE) who were treated surgically between April 2011 to December 2012.Patient treated with the clinical pathway (the CP group) were compared with patients who were treated with conventional treatment (the non-CP group).The following outcomes were compared:the average length of in-hospital stay,the hospital charges,patient's satisfaction,patient's knowledge about his/ her own health and postoperative complications.Results For the CP groups,the length of in-hospital stay,the hospital charges,the patient's satisfaction and the health knowledge for the patients were (10.25±1.26)d,(19600.25±1520.73) yuan,(46.4 5±2.14),(83.50±8.02),respectively.The corresponding figures for the non-CP group were (14.25 ± 1.50) d,(23931.25 ± 1629.17) yuan,(42.65 ± 1.93),(74.50 ± 12.60),respectively.There were significant differences between the 2 groups (t=-4.086,-4.074,8.351,3.811 ; P＜0.05).The postoperative complications,including bile leakage,bleeding,ascites and pleural effusion,were 2,0,2 cases in the CP group,and 0,4,5 cases in the non-CP group.There were no significant difference between the 2 groups (x2 =0.17,0,0.6; P＞0.05).Conclusion Our initial clinical experience showed that the clinical pathway decreased the length of in-hospital stay and hospital charges,and provided quality and efficient clinical services to patients with hepatic cystic echinococcosis.

Adult ; Female ; Humans ; Immunohistochemistry ; methods ; Male ; Meningeal Neoplasms ; immunology ; ultrastructure ; Meningioma ; immunology ; ultrastructure ; Microscopy, Electron ; Middle Aged ; Paraganglioma ; physiopathology

Objective To investigate the diagnosis and treatment of ruptured hepatic cystic echinococcosis (HCE).Methods The clinical data of 109 patients with HCE who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 1994 to December 2009 were retrospectively analyzed.The diagnosis was based on the results of serological examination,epidemiological history,clinical manifestation and imaging findings.Of the 108 patients who received surgical treatment,67 received classic endocystectomy(classic group)and 41 received improved endocystectomy(improved group).The operation time,operative blood loss,length of postoperative hospital stay,time of drainage,effusion and infection of residual cavity,biliary fistula,pleura]effusion,local recurrence,dissemination and implantation of HCE,and death of the 2 groups were compared.All data were analyzed using the t test and chi-square test.Results The diagnostic rates of ultrasound,computed tomography and magnetic resonance imaging were 93%(101/109),99%(70/71)and 7/7,respectively.The positive rate of serological examination was 100%(61/61).Of the 109 patients,1 died of anaphylactic shock.The operation time and operative blood loss were(3.2 ± 0.3)hours and(104.0 ± 11.5)ml in the classic group and(3.3 ±0.4)hours and(110.0 ±23.8)ml in the improved group,respectively.There were no significant differences in the operation time and operative blood loss between the 2 groups(t =-1.474,-1.758,P ＞0.05).The length of hospital stay and time of drainage were(15.3 ± 4.3)days and(28.0 ± 4.6)days in the classic group and(9.3 ± 1.2)days and(7.6 ± 0.8)days in the improved group,respectively.There were significant differences between the 2 groups in the length of hospital stay and time of drainage(t = 8.628,28.088,P ＜0.05).The incidence rates of effusion and infection of residual cavity,biliary leakage,local recurrence,dissemination and implantation of HCE of the classic group were significantly higher than those in the improved group(x2 =4.335,3.888,5.691,4.581,10.153,P ＜0.05).Twenty-one patients received reoperation because of HCE recurrence or severe complications.Conclusions Epidemiological history,clinical manifestation,imaging findings and serological examination are important for the diagnosis of ruptured HCE.Improved endocystectomy + peritoneal lavage with hypertonic saline + administration of anti-HCE drugs is the optimal treatment for ruptured HCE.

Objective To study the results of emergency treatment of ruptured hepatic cystic echinococcosis (HCE).Methods A standardized management protocol for hepatic echinococcosis was introduced by the First Hospital of Xinjiang Medical University in 2002.This study included 185 patients who received emergency treatment for ruptured HCE between 1994 and 2009.The patients were divided into group A (from 1994 to 2001) and group B (from 2002 to 2009).The clinical characteristics and surgical treatment results were compared retrospectively.Results In patients with ruptured HCE into the abdomen,classical endocystectomy (Group A1 ) resulted in significantly more postoperative complications in residual hepatic cavity,time of drainage,postoperative hospital stay,recurrence and peritoneal seeding than improved endocystectomy (Group B1 ) (P＜0.05).The operation time and blood loss were not significantly different between group A1 and B1 (P＞0.05).For patients with ruptured HCE into the biliary tree,classical endocystectomy (Group A2 ) resulted in significantly higher postoperative complications in residual hepatic cavity,time of drainage,postoperative hospital stay and recurrence than improved endocystectomy (B2) (P＜0.05).Operation time,blood loss and peritoneal seeding were not significantly different between group A2 and B2 (P ＞ 0.05). Only one patient (0.54％) died from allergic shock in this series of patients.Conclusions Improved endocystectomy was an efficacious surgical treatment for ruptured HCE and it is recommended for emergency surgery.

Objective To explore the efficacy of various managements of indurative biliary fistula after HCE operation.Methods 31 patients who underwent surgery for indurative biliary fistula after HCE operation in Xinjiang Medical University were studied retrospectively.Cholangiography and common bile duct exploration through a T tube were done in 15 patients,cholangiography and decompression through a T tube which led to the orifice of the fistula of the cavity in 8 patients,hepatectomy in 4 patients,lobe resection + choledochojejunostomy in 2 patients,total pericystectomy in 1 patient,and cavity abscess debridement in 1 patient for severe infection of the abdominal cavity,followed by hemihepatectomy after half a year.Result On follow-up of 1-8 years,choledochojejunostomy had to be done in 1 patient for stricture of the bile duct after T tube drainage,hepatectomy in 1 patient for bile leakage after the cavity abscess debridement operation,and bile leakage in 1 patient after hepatectomy although with drainage the patient was cured.Conclusion The results suggested that hepatectomy and total pericystectomy completely solved the problems arising from indurative biliary fistula.However,these procedures are complicated,and have higher operative risks.Cholangiography and common bile duct exploration solved the cavity-related problems.For patients with severe calcified cavities which communicated with large hepatic ducts,cholangiography and decompression through a T tube put into the orifice of the fistula of the cavity solved the indurative biliary fistula efficaciously and safely.

Objective To evaluate the effectiveness and safety of radical versus conservative surgery for hydatid liver cysts.Methods The Pubmed, EMBASE, MEDLINE, Cochrane Library, Chinese Biomedicine Database, CNKI, Wan Fang Databases, VIP Databases, Chinese scientific and technical journals full-text database and Chinese Journal of full text database were searched for randomized clinical trials or none-randomized clinical trials from January 2000 to January 2015.A Meta-analysis was performed with RevMan5.1.Results 10 studies with 2 123 patients were included into the final analysis.Meta-analysis demonstrated that the radical group was significantly longer in operation time [weighted mean difference (WMD) =25.11;95％ CI: 16.18-34.05;P ＜ 0.05], was significantly shorter in the length of hospital stay (WMD =-3.94;95％CI:-7.57-0.32;P ＜0.05), was significantly lower in the incidence of bile leak (OR =0.19;95％ CI: 0.07-0.49;P ＜ 0.05), was significantly lower in the incidence of residual cavity infection (OR =0.08;95 ％ CI: 0.04-0.15;P ＜ 0.05), and in the incidence of local recurrence (OR =0.10;95 ％ CI: 0.05-0.18;P ＜ 0.05) when compared with the conservative surgery group.Conclusions For hydatid liver cysts, radical surgical procedures had significantly lower rates of complications and recurrence.Thus, they are better treatments for hepatic cystic echinococcosis.