In the present study, we observed the effects of cholinergic enhancement by pyridostigmine (PD), a cholinesterases inhibitor, on GH release in both normal (n = 13) and GH deficient children and adolescents (n = 8). Responses of GH to insulin hypoglycemia were also observed. In the normal subjects, PD-induced serum GH peak levels were significantly higher than that induced by insulin (P

Objective To evaluate the surgical technique and procedures of transumbilieal breast augmentation with an inverse U-shape incision and insertion of saline-filled breast implants. Methods With specialized instruments, the subcutaneous tunnel was undermined to the inframammary crease after inverse U incision made along the umbilical border. The subpectoral space was dissected with a dissector after the advancement of obturator across the inframammary crease. The expander was inserted into the subpectoral pocket to be filled to obtain the high degree of symmetry of the breasts. Finally, the previous-ly prepared implants were inserted after the expander deflated and removed. Results All patients gained satisfactory results with no complications, such as hematoma, infection, implant deflation and Baker Ⅲ or Ⅳ capsular contracture. Conclusions Breast augmentation could be performed through umbilical inci-sion with the usage of saline-filled breast implant. This is an alternative of incisions in breast augmenta-tion.

Animals ; Calcium ; physiology ; Chloride Channels ; physiology ; Electrophysiological Phenomena ; Male ; Muscle, Smooth, Vascular ; cytology ; physiology ; Myocytes, Smooth Muscle ; physiology ; Pulmonary Artery ; cytology ; physiology ; Rats ; Rats, Wistar

Background and purpose:Stromal tumor is one of the common gastrointestinal mesenchymal tumors. There is certain understanding about the typical cases. However, the diagnosis of those occurring in rare location or with rare imaging findings is often difficult. This research summarized this kind of cases,in order to increase the radiological knowledge of the disease.Methods:This study retrospectively analyzed clinical, radiological and pathological data from 550 patients who had stromal tumor conifrmed by pathology in our hospital. Those with incomplete data were eliminated. Forty-nine patients were selected for further study according to the typical imaging findings.Results:Among these 49 patients, 9 were pathologically confirmed to have extra-gastrointestinal stromal tumor, while 40 patients had gastrointestinal stromal tumor. Among the patients with gastrointestinal stromal tumor, 22 were found in rare locations, 12 in retroperitoneal space, 3 in omentum majus and mesenterium, 5 in esophagus, and 2 in prostate. Obvious cystic degeneration was found in 16 patients. Bulky calciifcation, such as lfake or annulus, was found in 7 patients. The analysis result of risk-stratiifcation showed 19 patients were conifrmed as high-grade among the patients with tumors found in rare locations, 15 as high grade among those with obvious cystic degeneration, and 7 as high-grade among those with extra-gastrointestinal stromal tumor.Conclusion:Rare stromal tumor often occurs in the locations, such as retroperitoneal space, omentum majus and mesenterium. Obvious cystic degeneration and bulky calciifcation can be seen. The risk-stratiifcation of these patients often showed high-grade. Comprehensively analyzing its clinical features and imaging ifndings can help improve the diagnostic accuracy.

Objective To investigate the risk factors for early postoperative cognitive function in the patients with peritoneal surface malignancies after cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy(CRS-HIPEC).Methods Fifty-one patients(21 men and 30 women), ranged from 25 to 65 years,42-80 kg,ASA Ⅰ-Ⅲ,undergoing CRS-HIPEC under combined intrave-nous-inhalational anesthesia,were studied.Patients were assigned into postoperative cognitive dys-function (POCD)group or non-POCD group according to their performances of visual verbal learning test,concept shifting task,letter-digit coding test and stroop color-word test 1 day before operation and 7 days after operation.Years of education,medical history,duration of operation,intraoperative blood loss,frequency of cardiovascular events,amount of fluid infused per hour and VAS scores were recorded.Venous blood samples were taken at five time points:before surgery(T0 ),30 minutes after the beginning of the procedure(T1 ),30 minutes after the beginning of HIPEC(T2 ),at the end of the surgery(T3 )and 24 hours after the surgery(T4 ),to determine the concentration of serum amyloid A (SAA).pH,PaCO 2, Hb,blood glucose were recorded at T0-T2.Then the data was statistically analyzed.Results According to the diagnostic criteria,twenty patients developed POCD 20 (39.2%). There were significant differences between POCD and non-POCD groups on age,gender, pre-operative complications and the origin of tumor(P <0.05).The concentration of SAA increased from T2 and reached the peak at T4 ,and SAA concentration for patients in POCD group was higher than that for patients in non-POCD group(P <0.05).Compared with non-POCD group,the levels of blood glucose were significantly increased in POCD group at T2 (P <0.05).Conclusion CRS-HIPEC resul-ted in exaggerated and prolonged inflammatory response.Advanced age,female,diabetes,hyperten-sion,peritoneal carcinomatosis from ovarian cancer and endometrial cancer are associated with early POCD in the patients undergoing CRS-HIPEC.

Objective To explore imaging manifestations of hepatic epithelioid hemangioendothelioma (HEH). Methods CT and MR images in 14 patients with HEH proven by histopathology were retrospectively analyzed. Plain and two-phase contrast-enhanced CT scan were performed in 5 cases, non-contrast and multiphase contrast-enhanced MR scan were performed in 7 cases, CT and MRI were both performed in 2 cases. Characteristics of CT and MR T2WI images were classified and analyzed. All lesions were classified into three types:multiple, diffuse and solitary form. Results (1) Multiple form of HEH:228 lesions were found in 11 patients, including 178 lesions on MRI and 50 lesions on CT. On T2WI, three or two layered-target-signs with hyperintensity core were found in 79.2% (141/178) of the lesions. Three layer-target-sign included hyperintensity core, hypointensity rim and slightly high signal halo from the inside out. Two layer-target-sign included hyperintensity core and slightly high signal halo from the inside out. Characteristics of dynamic contrast-enhanced scan included peripheral two or three layered-rim-like enhancement in 66.3%( 118/178) of the lesions;peripheral, gradual rim-like enhancement with enhanced core in 27.0%( 48/178) of the lesions;heterogeneously mild enhancement in 2.2%( 4/178) of the lesions;centripetal enhancement in 4.5%( 8/178) of the lesions. Fifty lesions were found in CT, which showed low density nodules or masses with clear margins. Two-layered-black-target sign were found in 42 lesions in contrast-enhanced images, white-target sign were found in 3 cases, and centripetal enhancement was found in 5 cases. (2) Diffuse form of HEH:in one of the two cases of this type, the lesions could not be separated from normal liver parenchyma, gradual enhancements were found along with the vessels in the center of the lesions. (3) Solitary form of HEH: one case, the lesion showed heterogeneous density in non-contrast CT images and gradual enhancement in contrast-enhanced images. Conclusions We found some imaging characteristics of HEH. Two or three layered-target-sign on T2WI and black-target sign, white-target sign on contrast-enhanced images were unique imaging features of HEH.

Objective To evaluate the therapeutic effects of noninvasive bi-level positive airway pressure (BiPAP) ventilation after extubation in chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure.Methods Forty-one intubated COPD eases with severe respiratory failure due to pulmonary infection (pneumonia or purulent bronchitis) were involved in the study.At the time of pulmonary infection control (PIC) window,the extubation was conducted and followed by BiPAP ventilation in 21 cases (the experimental group),while the other 20 COPD cases with similar clinical characteristics,as the control group,who continuously received invasive mechanical ventilation after PIC window.Outcomes including the duration of invasive ventilation,the total duration of ventilation support,success rate,the incidence of ventilator associated pneumonia (VAP) and mortality rate were observed and compared between the two groups.Results The two groups had similar clinical characteristics and gas exchange at the time of PIC window (P ＞ 0.05 ).Compared with the control group,the experimental group had shorter duration of invasive mechanical ventilation (6.9±3.0) d vs.(13.1 ±4.3) d,t=5.38,P＜0.001),lower rate of VAP (1/20 vs.8/20,x2 =5.51,P=0.02) andhigher extubation rate (20/21 vs.13/20,x2 =4.19,P =0.04).Conclusion In COPD patients with intubation and mechanical ventilation for respiratory failure,BiPAP ventilation after extubation at the point of PIC window may improve patients' prognosis.

ObjectiveTo measure fetal lung volumes in different gestational age (GA) by using 3D ultrasound,and further to obtain the regression formula between fetal lung volume and GA.MethodsTotal 228 fetal lung data had been collected.By using the 3D reconstruction function in Philips Qlab,fetal lung volumes were obtained by subtracting the non lung volumes from the whole thoracic volumes.For each slice of 3D data,thoracic area and non-lung area were manually outlined.The contour stacking technique in Qlab was then used to transform 2D slices into 3D volumes.ResultsThe measurement results of total 228 cases indicate that the fetal lung volumes increase with the GA.The average lung volume at GA of 20 weeks was 8.85 cm3,and 70.5 cm3 at 36 weeks.The fetal lung volume increases about 3- 4 cm3 in each week,and the increasing trend turns to a little lower after 24 weeks.During 33 to 34 week there was a great increasing in fetal volumes.Second-order regression,exponential regression and logarithmic regression were respectively used to characterize the relationship between fetal lung volume and GA.The second-order regression formula was:Volume =39.52 - 4.48 × GA + 0.149 × GA2.The exponential regression formula was:Ln (Volume) =- 8.233 + 1.747 × Ln(GA2 ).The logarithmic regression formula was:Ln(Volume) =- 2.413 + 0.29× GA- 0.003 × GA2.The correlation coefficients of three formulas are equal,with r =0.99,P ＜ 0.001.Conclusions 3D ultrasound fetal lung volume measurement is useful for fetal lung maturity assessment and thus can provide important referential information for prenatal diagnosis.

Laser techniques are widely applied in medical research and military affairs. The characters of laser make it the best way to evoke pain.Pain induced by laser stimuli is influenced by laser parameters such as wavelength, pulse duration and stimulus area in addition to the properties of skin such as the distance from the brain, type and color of skin. In this review,both laser evoked pain and factors influencing it are discussed.

Background The dosage of verteporfin photodynamic therapy (PDT) for central exudative chorioretinopathy(CEC) depends on the calculation formula of Treatment of Age-related Macular Degeneration with Photodynamic Therapy Study Group(TAP)and Verteporfin in Photodynamic Therapy Study Group(VIP).Some local adverse responses or normal tissue damage have been noted under the standard dose of verteporfin during the treatment of CEC.So it is necessary to explore an appropriate therapeutic dosage of verteporfin.Objective This clinical study aimed to observe and compare the clinical efficacy and safety of different doses of verteporfin PDT for CEC.Methods Ninety eyes of 90 patients with CEC were enrolled in this study with the approval of the Ethic Commission of Affiliated Second Hospital of Nanchang University.Written informed consent was obtained before PDT.The patients were randomly divided into standard dose group,half dose group and 1/3 dose group.All of the patients received PDT.Standard dose(6 mg/m2),3 mg/m2 or 2 mg/m2 of verteporfin was applied in the three groups respectively,with the laser intensity 50 J/cm2.The patients were followed-up for 3 months.Repeat treating regimen was performed in the same way in the patient with fundus fluorescein leakage after initial PDT.Results The BCVA(logMAR) value was 0.44±0.36 after PDT in the standard dose group.Visual acuity improved in 20 patients (66.67％),stabilized in 8 patients(26.67％)and decreased in 2 patients (6.67％).The BCVA showed a significant difference between the preoperative and postoperative BCVA (t =6.719,P =0.000).CNV disappeared in 19 patients (63.33％),obviously improved in 7 patients (23.33％),partially disappeared in 3 patients (10.00％) and unchanged in 1 patient (3.33％).The central fovea thickness (CFT)value was significantly declined in postoperation compared with preoperation (t =5.758,P =0.000).Eight patients received secondary PDT with the recurrence rate 26.67％.In the half dose group,visual acuity improved in 18 patients(60.00％),stabilized in 11 patients(36.67％)and decreased in 1 patient (3.33％).CNV disappeared in 16 patients (53.33％),obviously improved in 8 patients (26.67％),partially disappeared in 5 patients (16.67％) and unchanged in 1 patient (3.33 ％).Significant difference was seen between the preoperative BCVA and postoperative BCVA(t=8.294,P =0.000).The decrease of C FT was significant in postoperation(t =8.493,P =0.000).Ten patients received secondary treatment with the recurrence rate 33.33％.In 1/3 dose group,visual acuity improved in 8 patients (26.67 ％),stabilized in 12 patients (40.00％),decreased in 10 patient (33.3％).CNV disappeared in 8 patients (26.67％),obviously improved in 8 patients (26.67％),partially disappeared in 6 patients (20.00％) and unchanged in 8 patient (26.67％).There was no significant difference between the preoperative BCVA and postoperative BCVA (t =0.536,P =0.596).The difference between preoperative CFT and postoperative CFT was insignificant(t =0.942,P=0.354).Fourteen patients received secondary PDT and 8 patients received three times with the recurrence rate 73.33％.Conclusions 3 mg/m2 verteporfin PDT for CEC shows a similar clinical efficiency and safety to 6 mg/m2 verteporfin.3 mg/m2 verteporfin PDT can decrease cost,but the effect of 2 mg/m2verteporfin PDT is not satisfacted.