Objective To investigate the prognostic effects of continuous renal replacement therapy on multiple organ dysfunction complicated with acute kidney injury.Methods Fifty nine patients who were diagnosed with multiple organ dysfunction syndrome (MODS) complicated with acute kidney injury (AKI) and underwent continuous renal replacement therapy (CRRT) were selected and grouped according to the Kidney Disease Improving Global Outcomes (KDIGO) staging.Their clinical data before CRRT were collected.The patients were grouped according to the Intensive Care Unit (ICU) prognosis,namely death and survival.The differences between two groups were analyzed.The multinomial logistic regression analysis was performed to explore the prognostic factors.Results With the increase of KDIGO stage,the Acute Physiology And Chronic Health Evaluation Ⅱ (APACHEII) score,Sequential Organ Failure Assessment (SOFA) score,the need for vasoactive drugs,and the number of cases with oliguria and ICU mortality rates showed an increasing trend,and those differences were statistically significant (P ＜ 0.05).After multivariate analysis,KDIGO Ⅲ stage,the number of failed organs,oliguria,and the mean daily fluid balance were independent risk factors of death in patients who were diagnosed with MODS complicated with AKI and underwent CRRT.Conclusions The KDIGO classification plays an important role in predicting the prognosis of patients with MODS complicated with AKI in need of CRRT.The number of failed organs,oliguria,and the mean daily fluid balance are also the risk factors for prognosis.

Objective To evaluate the accuracy of double contrast-enhanced ultrasonography(DCUS) and endoscopic ultrasonography (EUS) in the preoperative T staging of gastric cancer.Methods A total of 136 consecutive patients with histologically confirmed gastric carcinoma were enrolled into this study.DCUS and EUS were performed in all patients to estimate depth of invasionin (T stage) before surgery.All patients underwent surgery.The findings of the histopathologic examination of resected specimens were considered as gold standard and were retrospectively compared with the results of DCUS and EUS.Results The accuracy of DCUS and EUS in determining the T stage of gastric cancer were 80.1％ ( T165.5 ％,T2 79.5％,T386.5％,T487.5％) and 81.60％ ( T182.8％,T276.9％,T382.7％,T487.5％) respectively.There was no significant difference between two methods ( P ＞0.05) except T1 staging.Conclusions There is no significant difference between DCUS and EUS in overall T-staging of gastric cancers,but there is a significant difference between two methods in T1 staging.Either of these two methods has its advantages and disadvantages.If two methods are carried out simultaneously to make up for each other,the accuracy of preoperative T-staging of gastric cancers can be improved and this improvement can influence treatment algorithms.

Objective To evaluate clinical value of double contrast-enhanced ultrasonography(DCUS)in diagnosing gastric stromal tumors(GST). Methods The medical records of 26 patients with a histological diagnosis of GST were retrospectively reviewed. The correlation between DCUS features and pathological findings of the lesions was compared. Results Total 26 cases of GST were divided into low risk group( 16 cases) and high risk group (10 cases). The size,contour,liquefactive necrosis and enhancement distribution of lesions were markedly correlated with the pathobiologic behaviour of the tumor ( P ＜0.05). There was no significant difference in border and metastasis of lesions between two groups( P ＞0.05). It was shown that DCUS supplied statistically significant improvement in the localization diagnosis and detection of liquefactive necrosis versus oral contrast-enhanced ultrasonography ( P ＜ 0.05 ). Conclusions DCUS is considered as a valuable tool in diagnosing location as well as pathobiological behaviour of GST. It can provide the guidance and reference comments for treatment algorithms.

Objective To investigate the clinical value of double contrast-enhanced ultrasonography (DCUS)in diagnosing Lauren classification of advanced gastric carcinoma.Methods Fifty-eight patients with gastric cancer proved by endoscopic biopsy underwent preoperative DCUS examination,and the findings were compared with postoperative pathologic results via hematoxylin-eosin and alcian blue-periodic acid schiff(AB-PAS)staining.Results In 58 patients,34 cases were diagnosed as intestinal type and 24 cases as diffuse type by pathology after operation.In intestinal type,30 cases were enhanced as global homogeneous intensity by using DCUS.another 2 cases as"lamellar"model and the other 2 cases as heterogeneous intensity.However,in diffuse type,22 cases were enhanced heterogeneously with"barrier"signs in 5 cases,"map"signs in 9 cases and"lamellar"signs in 8 cases.the remaining 2 cases of diffuse type enhanced as homogeneous model.The sensitivity and specificity of heterogeneous enhancement in diagnosing diffuse type of advanced gastric cancer was 91.7%and 88.2%respectively,and the Youden's index was 0.8.Conclusions DCUS could be considered as a new valuable method to distinguish the Lauren classification and evaluate the invasiveness,metastasis and prognosis in patients with gastric carcinoma.

Objective To investigate the clinical value of double contrast-enhanced ultrasonography (DCUS)in Borrmann classification of advanced gastric carcinoma preoperatively. Methods A total of 69 patients with advanced gastric carcinoma were examined by ultrasound after taking oral contrast agent and bolus injection of SonoVue preoperatively.A comparison with final pathologic results was made after surgery. Results The accuracy of oral contrast-enhanced ultrasonography and DCUS in Borrmann classification of advanced gastric cancer were 78.3%and 91.3%,respectively.There was a significant difference between two methods(X2=4.087,P＜0.05).In addition,Kappa value of two methods were 0.73 and 0.90,respectively.Conclusions DCUS is a new valuable method for Borrmann classification with its high accuracy preoperatively.

Objective To evaluate the accuracy of double contrast-enhanced ultrasonography (DCUS) and endoscopic ultrasonography (EUS) in the preoperative N staging of gastric cancer.Methods Between June 2015 and September 2016,a total of 65 consecutive patients who were diagnosed with histologically confirmed gastric carcinoma and underwent surgery in the 2nd Affiliated Hospital of Wenzhou Medical University were enrolled into this study.DCUS and EUS were performed in all patients to estimate lymph node metastasis (N stage) within 5 days before surgery.The findings of the histopathologic examination of resected specimens were considered as gold standard and were retrospectively compared with the results of DCUS and EUS.The sensitivity,specificity and Youden index of DCUS and EUS were calculated.The difference of diagnostic performance between DCUS and EUS was assessed by chi-square test.Results There were 25 N-patients and 40 N + patients confirmed by pathology.Of all 25 N-cases,18 cases were diagnosed correctly by DCUS and 20 cases were diagnosed correctly by EUS;Of all 40 N + cases,32 cases were diagnosed correctly by DCUS and 31 cases were diagnosed correctly by EUS.The sensitivity,specificity and Youden index of DCUS were 80.0％,72.0％ and 0.52 respectively.The sensitivity,specificity and Youden index of EUS were 77.5％,80.0％ and 0.58 respectively.The overall accuracy of DCUS and EUS in N-staging were 76.9％ (50/65) and 78.5％ (51/65).There was no significant difference between two methods (x2=0.044,P=0.833).Conclusions There was no significant difference between DCUS and EUS in overall N-staging of gastric cancers.Either of these two methods had its advantages and disadvantages.When the two methods were combined,the accuracy of preoperative N-staging of gastric cancers could be improved and this improvement may influence treatment algorithms.