Objective To explore the metastasis rules of the lymph node in the colorectal cancer.Method Analyze the metastasis of the lymph node in 94 cases after D 3 radical resection.Results The lymph node metastasis of colorectal cancer was related with the position of tumor,the depth of tumor invasion and the differentiation of tumor cells,but not with patients's sex,age and the size of the tumor.The metastasis rate of the lymph node in rectal cancer was higher than that in colon cancer (P

Residency training is the mainstream model of doctor training around the world. Radiol-ogy teaching is an important part of the resident practice training. The purpose is improving and upgrading the quality of the residency training by establishing rigorous management system, intensifying the teachers disposition, setting tutorial system and reforming the examination and supervisor system, the residents.

Objective To discuss clinical value of 64-slice spiral CT scanning in fast evaluation of severe multiple trauma.Methods A retrospective study was carried out on data of 72 multiple trauma patients diagnosed with systemic 64-slice spiral CT scanning in our hospital from January 2006 to June 2008.Of all,28 patients with traffic injuries,24 with falling injuries,10 with blunt injuries,6 with stab injuries and 4 with explosive injuries.Results There were 72 multiple trauma patients with mean scanning time of 10.2 seconds.The CT scanning showed both craniocerebral and thoracic injuries in 30 patients,brain injuries in 16,thoracoabdominal injuries plus pelvic injuries in 10,extremity and brain injuries in 14 and systemic soft tissue injuries in 2.Isotropic characteristics and postprocessing function of 64-slice spiral CT scanning could accurately diagnose and evaluate injury severity of multiple trauma.Conclusions 64-slice spiral CT scanning is a fast and effective method for fast evaluating injury severity of multiple trauma,for it can not only shorten checking time,reduce movements of the patients and relieve the pain of the patients,but also can avoid defects induced by respiratory movement and provide fairly integrated imaging materials by its isotropic characteristics and pestprecessing function.

Objective To establish animal models of diffuse axonal injury (DAI) and discuss the early functional MRI findings.Methods Twenty-five adult white rabbits were divided into control group (n =5),mild DAI group and severe DAI group (n =6) according to random number.Mild DAI group was subdivided into mild DAI 3 h (n =6),1 day (n =4) and 1 week (n =4) groups.Routine MRI and diffusion tensor imaging (DTI) were performed.Parameters measured were fractional anisotropy (FA),apparent diffusion coefficient (ADC),axial diffusivity (AD) and radical diffusivity (RD).Results Significantly increased FA (P＜0.01) and decreased ADC (P＜0.05) and RD (P＜0.01) were detected in severe DAI group compared to control group,but there was no significant variation in AD between the two groups (P ＞ 0.05).Each parameter remained almost unchanged in mild DAI 3 h group and mild DAI 1 week group,but FA was increased (P ＜ 0.01) and RD decreased (P ＜ 0.05) in mild DAI 1 day group,with no changes of ADC and AD.Conclusion DTI is a sensitive way to detect the occurrence and development of DAI and can provide referential images for early DAI diagnosis.

Objective To analyze the correlation between white matter injury and cognitive dysfunction using diffusion tensor imaging (DTI).Methods Seventeen subjects with TBI hospitalized from October 2012 to September 2013 had Glasgow coma scale (GCS) score of ≥ 13 (mild injury group, 10 cases) and ≤ 12 (moderate-severe injury group, 7 cases).Another 17 healthy subjects were used as controls.All were submitted to DTI examination.Fractional anisotropy (FA) and apparent diffusion coefficient(ADC) values in genu corpus callosum, splenium corpus callosum, posterior internal capsule, anterior internal capsule, and cerebral peduncle were calculated using the Neuro 3D software.Correlations between FA and ADC with the mini-mental state examination (MMSE) score were evaluated.Results Moderate-severe injury group demonstrated significantly reduced FA values in genu corpus callosum and splenium corpus callosum, and significantly increased ADC values of genu corpus callosum, splenium corpus callosum, posterior internal capsule and cerebral peduncle when compared to control group (P ＜0.05 or 0.01).FA and ADC values in the regions of interest did not differ significantly between mild injury group and control group (P ＞ 0.05).In the genu corpus callosum and splenium corpus callosum, FA values were positively correlated with MMSE score (r =0.636, 0.601), while ADC values were negatively correlated with MMSE score (r =0.552, 0.660).Conclusions DTI reveals the cerebral white matter lesion that is undetectable using CT and conventional MRI.DTI is a helpful tool to evaluate the degree of cognitive function in patients with TBI, which provides the basic reference for the clinical treatment and prognosis.

BACKGROUNDTo analyze the causes of computed tomographic misdiagnosis of pulmonary carcinoma.

METHODSFrom September 1991 to January 2002, 45 cases of pulmonary carcinoma misdiagnosed by CT were analyzed retrospectively. Twenty-six cases of pulmonary tuberculosis and 15 cases of pulmonary pneumonia misdiagnosed as pulmonary carcinoma by CT were studied as control subjects. All of these cases were confirmed by surgery and clinical course. The CT appearances of these cases were independently reviewed in a double blind method by three experienced radiologists. Then they discussed together in order to search for the factors of CT misdiagnosis and formed a consensus interpretation.

RESULTSForty-five cases of pulmonary carcinoma were misdiagnosed as pulmonary tuberculosis in 19 cases, pneumonia in 14 cases, abscess in 4 cases, pleural mesothelioma in 2 cases, normal in 2 cases, and others in 4 cases. The fundamental manifestations of misdiagnosed cases were lobar or segmental shadows (26 cases), solitary mass or nodule (19 cases).The reasons of CT misdiagnosis were very confusing. The main factors were:(i) Missed diagnosis (2 cases, 4.5%). One case had an endobronchial mass and another had the erosion of rib. (ii) Twenty-four cases (53.3%) due to mis interpretation and lack of experience. (iii) The manifestations in CT were atypical (19 cases,42.2%).

CONCLUSIONSNot identifying accurately the CT appearances and excessively emphasizing the specificity of some signs are the main causes of the misdiagnosis. A reasonable and careful CT examination, summarizing analysis combined with clinical findings, and the accumulation of diagnostic experience will help to reduce the CT misdiagnostic rate of pulmonary carcinomas.

Objective:To evaluate the safety and effectiveness of Kangduo endoscopic surgical robot system for partial nephrectomy.Methods:Consecutive patients with stage T 1 renal tumor meeting the inclusion criteria from the Department of Urology, Peking University First Hospital from December 2020 to February 2021 were prospectively enrolled. All patients underwent partial nephrectomy with the Kangduo endoscopic surgical robot system after signing the informed consent. Clinical data including preoperative, perioperative and postoperative pathology and follow-up were collected. Results:Among the 26 patients, there were 16 males and 10 females, with a median age of 53(33-74) years, and a median body mass index of 25.99(20.90-32.91) kg/m 2. There were 12 cases of left kidney tumor and 14 cases of right kidney tumor. The median tumor diameter was 2.2(1.0-3.5) cm. The median time of warm ischemia was 17.7(7.1-29.2) minutes, and all of them were less than 30 minutes. The median docking time was 4.7(2.3-9.9) minutes, and the median time of robotic arm operation was 65.0 (37.0-155.0) minutes. The median National Aeronautics and Space Administration Task Load Index (NASA-TLX) score was 5.3 (2.0-28.0), and no instrument-related adverse events occurred intraoperatively. The median postoperative hospital stay was 4 (4-5) days. All tumor margins were negative on pathologic reports. No Clavien Ⅱ stage operative complications occurred in all patients during perioperative period and 1 month after the surgery. Conclusions:The partial nephrectomy using the kangduo endoscopic surgical robot system were completed successfully, and no instrument-related adverse events and complications occurred, showing that this surgical system used for partial nephrectomy is safe and effective.

BACKGROUND: The KangDuo-Surgical Robot-01 (KD-SR-01) system is a new surgical robot recently developed in China. The aim of this study was to present our single-center experience and mid-term outcomes of urological procedures using the KD-SR-01 system. METHODS: From August 2020 to April 2023, consecutive urologic procedures were performed at Peking University First Hospital using the KD-SR-01 system. The clinical features, perioperative data, and follow-up outcomes were prospectively collected and analyzed. RESULTS: A total of 110 consecutive patients were recruited. Among these patients, 28 underwent partial nephrectomy (PN), 41 underwent urinary tract reconstruction (26 underwent pyeloplasty, 3 underwent ureteral reconstruction and 12 underwent ureterovesical reimplantation [UR]), and 41 underwent radical prostatectomy (RP). The median operative time for PN was 112.5 min, 157.0 min for pyeloplasty, 151.0 min for ureteral reconstruction, 142.5 min for UR, and 138.0 min for RP. The median intraoperative blood loss was 10 mL for PN, 10 mL for pyeloplasty, 30 mL for ureteral reconstruction, 20 mL for UR, and 50 mL for RP. All procedures were successfully completed without conversion, and there were no major complications in any patient. The median warm ischemia time of PN was 17.3 min, and positive surgical margin was not noted in any patient. The overall positive surgical margin rate of RP was 39% (16/41), and no biochemical recurrence was observed in any RP patient during the median follow-up of 11.0 months. The surgical success rates of pyeloplasty and UR were 96% (25/26) and 92% (11/12) during the median follow-up of 29.5 months and 11.5 months, respectively. CONCLUSION The KD-SR-01 system appears feasible, safe, and effective for most urological procedures, based on our single-center experience.
Male ; Humans ; Robotic Surgical Procedures/methods* ; Robotics ; Treatment Outcome ; Retrospective Studies ; Ureter/surgery* ; Urologic Surgical Procedures/methods* ; Laparoscopy/methods*

Humans ; Urinary Bladder Neoplasms/pathology* ; Carcinoma, Transitional Cell/pathology* ; Genetic Markers ; Biomarkers, Tumor/genetics* ; Urothelium/pathology*