1.Clinical analysis of minimally invasive surgery under thoracoscopy and laparoscopy in the treatment of esophageal cancer
Changyun MA ; Fang WU ; Yinfeng SONG ; Yunjian QU
Clinical Medicine of China 2017;33(3):213-216
Objective To analyze the feasibility and clinical effect of thoracoscopy and laparoscopy minimally invasive surgery in the treatment of esophageal cancer.Methods Eighty-six cases patients with esophageal cancer who were underwent the minimally invasive surgery under thoracoscopy and laparoscopy for esophageal cancer in the Central Hospital of Hengyang from August 2014 to February 2016 were retrospectively analyzed.Operation time,bleeding volume,indwelling time of thoracic drainage tube,length of stay,number of lymph node dissection,postoperative complications and so on were recorded.Results All patients were successfully completed surgery,no intraoperative death and intraoperative massive hemorrhage.Operation time was 270-380 min,the amount of bleeding during the operation was 50-550 ml.Chest drainage tube was removed from 3 to 10 d after operation.The number of lymph node dissected was 10-19.Lymph node metastasis was found in 13 cases.Postoperative cervical anastomotic fistula in 6(7.0%) cases,hoarseness in 8(9.3%) cases,7(8.1%) cases of pulmonary infection,and 1(1.2%) case of chylothorax,all were cured after conservative treatment.Postoperative hospital stay was 9-20 d.The patients were followed up for 3 to 21 months,1 case had lymph node metastasis in 10 months after surgery,and the other patients had no recurrence,metastasis or death.Conclusion Minimally invasive surgery under thoracoscopy and laparoscopy for esophageal cancer is safe and feasible,clinical effect is satisfied,it is worthy of further clinical application.
2.Evaluation of multiparametric MRI in diagnosing early prostate cancer:a study based on PI-RADS version 2
Yongsheng ZHANG ; Huan YANG ; Youjun CAO ; Yinyu WANG ; Zhitian ZHANG ; Yinfeng MA ; Zaiqiu ZHAO ; Feng CUI
Journal of Practical Radiology 2017;33(7):1052-1055,1083
Objective To investigate the diagnostic value of multiparametric MRI in early prostate cancer(PCa) based on PI-RADS version 2.Methods 27 surgically-proved early PCa patients were collected in this retrospective study.T2WI,DWI and DCE were evaluated by two blinded radiologists.By 12 sub-region classification method the possibility of the presence of cancer at each sub-region was scored according to the PI-RADS V2.The receiver operating characteristic (ROC) curve was used to analyze the diagnosic efficacy of the following 4 protocols:T2WI alone(protocol 1),T2WI+DWI(protocol 2),T2WI+DCE(protocol 3),T2WI+DWI+DCE(protocol 4).The sensitivity,specificity and accuracy for each protocol were calculated.The average scores of cancerous sub-regions and non-cancerous sub-regions were calculated and the independent sample t test was used to compare the four protocols.Results 324 sub-regions were analyzed in 27 early PCa patients and then divided into 119 cancerous sub-regions and 205 non-cancerous sub-regions,including 64 peripheral zone cancerous sub-regions and transition zone cancerous sub-regions.In protocol 1-4, the average scores of cancerous sub-regions in orderwere 3.13±1.19,3.27±1.15,3.28±1.23, 3.33±1.16,respectively.Non-cancerous sub-regions's scores in order were 1.98±0.90,1.91±0.91, 2.03±0.99,1.94±0.96 respectively and there were significant differences among each protocol (P<0.05).The area under the ROC curve of the 4 protocols for region-based analysis were displayed in descending order: protocol 4 (0.819), protocol 2 (0.810), protocol 3 (0.772), protocol 1 (0.765) and there were no significant differences between any two protocols (P>0.05).In four protocols, the sensitivity in order were 45.40%, 56.30%, 59.70%, 61.34%, while the specificity in order were 95.10%, 96.10%, 89.80%, 96.60%, and the accuracy in order were 76.85%, 81.48%, 78.70%, 83.65%.Conclusion Multiparametric MRI can improve the diagnostic accuracy for the detection of early PCa, and T2WI+DWI+DCE is with the highest value.The PI-RADS V2 system is a better semi quantitative method for evaluation of early PCa.
3.Multivariate Logistic regression analysis for diagnosis of peripheral zone prostate cancer on T2 WI
Yongsheng ZHANG ; Zhitian ZHANG ; Zuhua CHEN ; Yinfeng MA ; Zaiqiu ZHAO ; Miaoer LI ; Xiangyang GONG
Journal of Practical Radiology 2016;32(12):1898-1901
Objective To evaluate the diagnostic capabilities of T2 WI features in peripheral zone prostate cancer.Methods The characteristics of T2 WI in 56 cases of peripheral zone prostate cancer,75 cases of benign prostatic hyperplasia and 7 cases of prostatitis confirmed by pathology were analyzed retrospectively.Eight indexes were initially screened byχ2 test,then indexes with significant difference were entered into multivariate Logistic regression analysis.Results The indexes showing statistical differences between prostate cancer and benign prostatic disorders were as following:lesion shape,signal intensity,signal uniformity,boundary of peripheral zone and transition zone,the volume of peripheral zone and prostatic capsule on T2 WI (P<0.05).Margin of lesion and capsule between two groups were not statistical differences (P>0.05).By multivariate Logistic analysis,the statistically significant difference were found in lesion shape, the volume of peripheral zone,prostatic capsule and boundary of peripheral zone and transition zone.Conclusion The lesion shape, volume of peripheral zone and prostatic capsule on T2 WI are independent risk factors for peripheral zone prostate cancer.
4.MRI evaluation of argon-helium cryoablation therapy for the treatment of prostate cancer:an analysis of 16 cases
Zhitian ZHANG ; Feiqun ZHENG ; Yongsheng ZHANG ; Dong TANG ; Miaoer LI ; Xiaping JIN ; Yinfeng MA
Journal of Interventional Radiology 2015;(6):527-529
Objective To evaluate MRI in judging the therapeutic effect of argon-helium cryoablation therapy for prostate cancer. Methods The clinical data and imaging materials of 16 patients with prostate cancer , who had received ultrasound-guided argon-helium knife cryogenic treatment at authors ’ hospital during the period from March 2012 to Oct. 2014, were retrospectively and comprehensively analyzed. The preoperative and postoperative laboratory test results were compared with MRI findings, and the ablation effect was assessed, focusing on the surgical residue, metastasis, etc. Results One months after the surgery, MRI demonstrated that satisfactory ablation extent was obtained in all patients, the ablated tumor tissue was characterized by long-T2 signal and no obvious recurrence could be found on DWI and DCE-MRI. A slight decrease of PSA level was observed. Six months after the surgery, MRI revealed that the prostate size was significantly reduced, PSA level was markedly decreased and no obvious evidence of recurrence was observed. No severe postoperative complications, such as urethral necrosis, urethral stricture or urethro-rectal fistula, occurred. During the 6-month following-up time, one patient died from other causes. Conclusion MRI has excellent clinical application value in estimating the ablation extent and in judging postoperative recurrence or metastasis of prostate cancer after argon-helium cryoablation treatment.
5.Comparison of two methods for evaluation of underneath eye wrinkles
Yinfeng JIANG ; Wenjuan ZHANG ; Leilei ZHI ; Weiguang HUA ; Qin YU ; Laiji MA ; Nan LU
Chinese Journal of Medical Aesthetics and Cosmetology 2017;23(1):43-46
Objective To investigate the applicability of clinical grade and a non-contact measurement method in evaluation of underneath eye wrinkles and to compare two methods.Methods A lot of 46 healthy Chinese women were recruited for this study.Underneath eye wrinkles severity was evaluated using clinical grade and a non-contact measurement method.The correlations were calculated for clinical grade and non-contact measurement parameters and age.The non-contact measurement parameters were classified by factor analysis.The correlations between age,clinical grade and factors were analyzed.Results The correlation coefficient between clinical grade in comparison to subject's age was 0.818.The parameters getting from non contact measurement were obviously correlated with age and clinical grade except SEr and SEsc;the correlation coefficients between parameters and age were-0.601 to 0.605;the correlation cofficients between parameters and clinical grade were-0.630 to 0.570.The non-contact measurement parameters could be classified into two factors;one represented wrinkle depth and roughness;the other represented wrinkle width and counts.These two factors were also obviously correlated with age and clinical grade.Conclusions Clinical grade and non contact measurement methods are both applicable in evaluation of underneath eye wrinkles.The parameters getting from two methods are obviously correlated with each other.
6.Value of T2WI scores in diagnosis and differential diagnosis of transition zone prostate cancer
Yongsheng ZHANG ; Feng CUI ; Zhitian ZHANG ; Youjun CAO ; Yinfeng MA ; Zaiqiu ZHAO ; Miao'er LI ;
Journal of Practical Radiology 2017;33(9):1386-1389
Objective To evaluate the value of T2WI scores for diagnosis and differential diagnosis of transition zone prostate cancer(PCa).Methods T2WI of 43 cases of transition zone PCa and 91 cases of benign prostatic hyperplasia(BPH) were analyzed retrospectively.Transition zone T2WI signs were divided into the main signs and the secondary signs, which were given different scores and were evaluated separately by receiver operating characteristic (ROC) curve for their diagnostic value.Results In a total of 11 scores sections (-1-10), as the increase of scores, the sensitivity of transition zone PCa was decreased while the specificity and positive predictive value were both increased.According to the ROC curve, when the critical value of scores≥4.5, the sensitivity, specificity, negative predictive value, and the accuracy were 81%,73.3%,90.9%,70.4% respectively.When the scores ≥8.5,the specificity and positive predictive value were both 100%.When the scores ≥0.5 and ≥1.5,the negative predictive value were 100%.Conclusion T2WI scores can quantitatively analyze the transition zone PCa,which has an important value to improve the clinical diagnosis and guide treatment.
7.Assessment of platelet function using a Platelet Function Analyzer-100 for metabolic syndrome patients
Tingting WANG ; Li FU ; Yinfeng ZHANG ; Lingling LIU ; Lili MA ; Leilei DING ; Li LI
Chinese Journal of Health Management 2021;15(2):163-166
Objective:Metabolic syndrome (MS) patients and determine factors related to platelet hyperactivation.Methods:A total of 999 participants (822 males and 177 females) were enrolled. Participants were divided into two groups according to the metabolic index: MS group (501) and normal control (NC) group (498). Platelet function was tested with PFA100 (Siemens USA, Deerfield, Illinois) which measures the time it takes for blood to occlude an aperture (closure time, CT) following stimulation with collagen and adenosine diphosphate. Statistical analyses were performed using the SPSS statistical software package, version 22.0 (IBM Corporation, Armonk, NY, USA).Results:MS group had significantly shorter CT values compared with NC group (106.6±27.8s) vs (113.7±27.9s). Higher BMI, WC, BP, TC, TG, LDL-C, UA, and PRL were correlated with shorter CT values (all P<0.05). Conclusion:Our results indicated platelet hyperactivation exists in MS which was related to obesity and elevated blood pressure, blood lipids, uric acid, and PLR.
8.Effect of body mass index on the assisted reproductive outcome of frozen-thawed embryo transfer in patients with polycystic ovary syndrome
Yinfeng ZHANG ; Haining LUO ; Rui SHI ; Yaojia ZHANG ; Xiaomei TAI ; Xinyu HU ; Junfang MA ; Xinyan WANG ; Yunshan ZHANG ; Pengpeng QU
Chinese Journal of Obstetrics and Gynecology 2021;56(4):257-263
Objective:To investigate the effect of body mass index (BMI) on clinical pregnancy and neonatal outcomes in patients with polycystic ovary syndrome (PCOS) during frozen-thawed embryo transfer.Methods:A total of 650 patients with PCOS who received routine in vitro fertilization or intracytoplasmic sperm injection treatment for frozen-thawed embryo transfer from June 2014 to June 2019 in Tianjin Central Hospital of Gynecology Obstetrics were retrospectively analyzed. According to BMI, PCOS patients were divided into group A (18.5≤BMI<23 kg/m 2, n=253), group B (23≤BMI<25 kg/m 2, n=167), and group C (BMI≥25 kg/m 2, n=230). The general information, clinical pregnancy outcomes, pregnancy complications, the incidence of macrosomia and low-birth-weight infants were compared in the three groups, and the influencing factors of neonatal birth weight were analyzed. Results:The embryo implantation rate, clinical pregnancy rate, and ongoing pregnancy rate all showed downward trend with the increase of BMI, but the differences were not statistically significant (all P>0.05). The live birth rate in group C [47.0% (108/230)] was significantly lower than those in groups A and B, with statistical significance ( χ2 =7.43, P=0.024). The late miscarriage rate was higher in group C [9.4% (13/139)] than in groups A and B ( χ2 =7.66, P=0.022). The birth rates of macrosomia in groups B [22.2% (16/72)] and group C [21.1% (16/76)] were significantly higher than that in group A, and the difference was statistically significant ( χ2 =14.15, P=0.001). There was no statistically significant difference in the incidence of gestational diabetes between the three groups ( χ2 =3.81, P=0.149). The incidence of hypertension disorders complicating pregnancy increased with the increase of BMI, and the difference was not statistically significant ( P>0.05). Regression analysis showed that macrosomia was significantly associated with maternal pre-pregnancy BMI and gestational weeks, and the risk of macrosomia increased by 15% (95% CI: 3%-28%) for every increase in maternal BMI. Conclusions:The embryo implantation rate, clinical pregnancy rate, and ongoing pregnancy rate of PCOS patients in frozen-thawed embryo transfer cycles show downward trend with the increase of BMI. Obese patients with PCOS have a significant increase in late miscarriage rate and a significant decrease in live birth rate. The incidence of hypertension disorders complicating pregnancy in PCOS patients in the obese group has an increasing trend, and the birth rate of macrosomia has increased significantly. Therefore, it is recommended that obese women with PCOS lose weight scientifically before pregnancy to improve pregnancy and neonatal outcomes.
9.Application of total mesoesophageal excision combined with sanye lymph node dissection in radical resection of esophageal carcinoma under thoracoscopy and laparoscopy
Changyun MA ; Fang WU ; Yinfeng SONG ; Zhijian HUANG ; Jinwen LIAO
Clinical Medicine of China 2018;34(4):312-317
Objective To evaluate the clinical efficacy of total mesoesophageal excision and sanye lymph node dissection in the radical resection of esophageal carcinoma under thoracoscopy and laparoscopy,and to investigate its safety and feasibility, and to find a more reasonable and effective surgical treatment of esophageal carcinoma. Methods One hundred and twenty-six cases of esophageal cancer who underwent the minimally invasive surgery under thoracoscopy and laparoscopy for esophageal cancer in Central Hospital of Hengyang from October 2015 to September 2017 were retrospectively analyzed. Among them,Sixty-four patients accepted total mesoesophageal excision and sanye lymph node dissection under thoracoscopy and laparoscopy (observation group ), Sixty-two cases accepted with conventional esophagectomy under thoracoscopy and laparoscopy ( control group) . The operation time, blood loss, indwelling time of thoracic drainage tube, postoperative drainage volume,postoperative hospitalization time,number of lymph node dissection,lymph node metastasis degree,perioperative complications of the two groups were analyzed and compared. The number of lymph node dissection and lymph node metastasis degree in different regions were compared between the two groups. The number of recurrence and death were recorded in the two groups. Results Compared with the control group,the operation time was longer in the observation group((264. 9±32. 9) min vs. (233. 5±30. 4) min,t= -5. 56,P<0. 001),but blood loss was less((152. 7±26. 4) ml vs. (235. 5± 30. 6) ml,t = 16. 27,P<0. 001). There was no significant difference in the indwelling time of thoracic drainage tube, postoperative drainage volume or postoperative hospitalization time between the two groups (P>0. 05). The number of lymph nodes in the observation group was significantly higher than that in the control group ((32. 7±15. 5) pieces vs. (20. 9±11. 2) pieces,t = - 4. 93,P< 0. 001),and lymph node metastasis degree in the observation group was smaller than that of the control group ( 6. 7% vs. 9. 3%, χ2 = 7. 22, P < 0. 01) . There were no significant differences in perioperative complications such as pulmonary complications, arrhythmia, anastomotic fistula, chylothorax,hemorrhage,recurrent laryngeal nerve injury,tracheal injury and perioperative death (P>0. 05). Left and right recurrent laryngeal nerve,thoracic esophagus,celiac artery lymph node dissection of the number of observation group was higher than that of the control group ((4. 7 ± 3. 2) pieces vs. (1. 5 ± 1. 4) pieces, t= -7. 25;(6. 0±2. 7) pieces vs. (3. 1±1. 7) pieces,t = -7. 12;(5. 7± 2. 4) pieces vs. (3. 2± 1. 9) pieces,t= -6. 48;P<0. 001). Left and right recurrent laryngeal nerve,thoracic esophagus lymph node metastasis degree in the observation group was smaller than that in the control group (8. 7%(26/ 300) vs. 18. 1%(17/ 94),χ2= 6. 53;8. 9%(34/ 382) vs. 17. 9%(35/ 195),χ2 = 10. 04;P<0. 05) . There were no significant differences in the recurrence rate of tumor recurrence at 1 and 24 months after operation in the observation group and the control group(3 cases(4. 7%) vs. 4 cases(6. 5%),χ2 = 0. 92,P > 0. 05) . There were no deaths in the two groups. Conclusion Total mesoesophageal excision and three-field lymph node dissection in radical resection of esophageal carcinoma under thoracoscopy and laparoscopy is safe and feasible,the recent effect does not increase the surgical complications, but its long-term effect need a lot of long-term follow-up. A relatively thorough cleaning of the esophageal mesentery and its lymph nodes can minimize the tumor in the subendothelial micrometastasis,and is beneficial for the prognosis of patients with esophageal cancer.
10.Assessment of the degree of skin color change by using skin tone index
Wenjuan ZHANG ; Yinfeng JIANG ; Weiguang HUA ; Laiji MA ; Nan LU
Chinese Journal of Medical Aesthetics and Cosmetology 2020;26(2):145-148
Objective:To measure the skin color parameters of Chinese women with non-invasive instruments test, and to validate assessment scales (VAS) and image analysis. Skin tone index (STI) of Chinese women was created by PLS-VIP method, and then used to the overall evaluation of Chinese women skin color.Methods:The skin color scale by VAS, parameters measured by tristumulus colorimeter, narrow-band-simple reflectance meter and image analysis were administered at the cheek of 60 famle subjects. The correlations among all the parameters collected by the instruments and scales by VAS were investigated, and then the main impact factors of skin color grade were analyzed. The STI model was created by principal component analysis and further tested.Results:With b value exception, skin color score was significantly correlated with the instrument parameters. The absolute values of coefficients were from 0.6898 to 0.8648. Int, L, BS, MI and EI were the most important parameters which influenced the consumer's perception of skin visual color. The SWI=0.47*Int+ 0.47*L+ 0.43*BS-0.44MI-0.43EI was created by PLS-VIP. The coefficient between SWI and skin color scale was -0.834 ( P<0.0001). Conclusions:STI could be effectively and comprehensively representative of the degree of skin color change.