1.Color Doppler flow imaging in acute cholecystitis to predict technical difficulties during laparoscopic cholecystectomy
Chuanyu WANG ; Wenli JIANG ; Na MA
Chinese Journal of Postgraduates of Medicine 2010;33(2):11-13
Objective To evaluate the value of preoperative color Doppler flow imaging findings for predicting possible difficuulties encountered during laparoscopic cholecystectomy (LC).Methods Eighty-six Datients with acute cholecystitis underwent color Doppler flow imaging examination were divided into operation difficult group(67 cases)and operation easy group(19 cases)according to the diffculty score.The parameters were measured pre-operation including the volume of gallbladder,the thickness of the gallbladder wall,the condition of arterial flow in the gallbladder wall,the conditions of gallbladder cavity and gallbladder fossa and the intra-and extra-hepatic bile duet.The relationships among imaging results,operation difficulties and operation findings were investigated.Results Gallbladder volume,gallbladder wall thickness.the presence rates of plentiful arterial flow in the gallbladder wall,adhesion of gallbladder and stone incarceration In operation difficult group were significantly different from those in operation easy group [(52.6±14.6)mm~3 vs(32.6±10.4)mm~3,(9.7±4.1)mm vs(3.8±0.9)mm,89.5%(17/19)vs 17.9%(12/67),78.9%(15/19)vs 11.9%(8/67),10.5%(2,19)vs 0(0/67)](P<0.05 or<0.01).The accurate rate was 94.2%(81/86)in predicting.Conclusion Preoperative color Doppler flow imaging is helpful in predicting difficulties of LC.
2.Tumorigenicity of human bone marrow mesenchymal stem cells during proliferation in vitro and following differentiation into cardiomyocytes
Linye MA ; Guoyou DAI ; Yuhao LIU ; Chuanyu GAO
Chinese Journal of Tissue Engineering Research 2007;0(14):-
0.05).No significant difference was found in c-myc and p16 protein.CONCLUSION:Human BMSCs cultured in vitro in autologous serum meets the requirement of clinic,with enough number,well growth,without karyotype variation,and BMSCs can differentiate into cardiomyocytes.No tumorigenesis is found in body after implantation.Moreover,no significant difference is seen in telomerase activation and c-myc and p16 gene expression.
3.Psychological stress increases expression of aortic plaque intercellular adhesion molecule-1 and serum inflammatory cytokines in atherosclerotic rabbit model
Muwei LI ; Xianpei WANG ; Lei YANG ; Chuanyu GAO ; Yexin MA
Journal of Geriatric Cardiology 2008;5(4):235-242
Plaque rupture,platelet aggregation,and thrombogenesis are the main mechanisms of acute coronary syndrome (ACS),and inflammation factors play key roles in plaque unstability.Psychological stress promotes acute inflammatory response,leading to increased circulating levels of C-reactive protein (CRP),IL-6,and serum intercellular adhesion molecule (sICAM)-1.But it is not clear that whether psychological stress has a direct effect on atherosclerotic plaque stability.The purpose of this study was to investigate effects of chronic psychological stress on inflammatory marker (ICAM-1 ) in atherosclerotic plaque,and inflammatory markers in peripheral blood.Materials and methods Sixty male rabbits were randomized into 2 groups:the control group (n =10) and the atherosclerotic group (n =50).The latter were fed on high fatty diet and were given a large dose of vitamin D3 (3 600 000IU/kg) via intraperitoneal injection.After 8 weeks,the atherosclerotic model was estaslished.Then the 50 atherosclerotic model rabbits were divided into 3 subgroups:no-stress subgroup (n = 16),physiological stress subgroup (n = 16) and psychological stress subgroup (n =18).In physiological stress subgroup and psychological stress subgroup,drinking was cut from twice a day to once a day.At the same time,psychological stress subgroup was given empty bottle stress,and this process lasted for 2 weeks.One hour after the last stress,the blood samples were collected and the serum levels of CRP,IL-6 amd ICAM-1 were tested by radioimmunoassay or enzyme linked immunosorbent assay.The aorta and heart were extracted for pathology examination,and the express of ICAM-1 was tested by immunohistochemical examination.Results (1) After effective atherosclerotic animal model construction,the expression of ICAM-1 in aorta was higher in atherosclerotic group than that in control group (P<0.01),and was notably higher in psychological stress subgroup than that in no-stress subgroup or in physiological stress subgroup (2.18±0.17 vs 1.58±0.22,1.22±0.15,P<0.001,respectively).The expression in physiological stress subgroup was higher than that in no-stress subgroup (584±0.22 vs 1.22±0.15,P=0.001).(2) The serum level of IL-6 (51.80±4.60 pg/ml vs 27.60±4.19 pg/ml,8.01±1.39 pg/ml,7.83±1.37 pg/ml),sICAM-1 ( 1.24±0.25 vs 0.85±0.09,0.62±0.17,0.57±0.11),CRP ( 1.004±0.37 vs 0.90±0.29,1.01±0.22,0.71±0.13) in psychological stress group were significantly higher than that in other groups (All P<0.05).There was a positive relationship between the serum level of CRP,IL-6 and ICAM-1 and the expression of ICAM-1 in aorta wall ( r =0.59,r =0.75,r =0.87,P<0.01,respectively).Conclusions Psychological stress induces an increased expression of ICAM-1 in aortic atherosclerotic plaque,a higher serum level of CRP,IL-6,and sICAM-1 expression.Psychologial stress has a direct effect on the transition from stability to unstability through in-plaque and out-plaque inflammation.The serum level of CRP,IL-6 and ICAM-1 can reflex the inflammatory degree in atherosclerotic plaque.(J Geriatr Cardiol 2008;5:235-242)
4.Color Doppler ultrasonography in monitoring thrombosis of lower limb deep vein after malignantthoracic tumor surgery
Na MA ; Xiujie HAN ; Huaibin WANG ; Chuanyu WANG ; Wenli JIANG
Chinese Journal of General Practitioners 2012;11(3):231-233
Sixty patients underwent surgery for malignant thoracic tumor were evenly randomized into control group (group A) and treatment group (group B).0.3 ml low-molecular-weight heparin was injected per 12 h for 3 d in group B from 24 h after surgery.Bilateral venous sonography of lower extremities were performed before and d1,d3 after operation.Blood coagulation marks PLT,PT,APTT,Fibrinogen (FIB)and D-dimer were determined at the same time.Diagnosis of calf vein thrombosis after surgery was confirmed by color Doppler sonography in 7 patients:1 in group B (3%) and 6 in group A (20%) (P < 0.05 ).Thrombosis at calf intermuscular vein was found in 6 patients and thrombosis at posterior tibial vein in 1 patient.FIB and D-dimer had no significant difference on the dl ( P > 0.05 ) between two groups,but significantly lower on the d3 after surgery in group B than that in group A ( P < 0.05 ).Low-molecularweight heparin reduced blood hypercoagulation state and thrombosis.Color Doppler sonography can be a valuable method for detecting asymptomatic deep vein thrombosis in the early stage after surgery and monitoring the efficacy of thrombosis prevention.
5.Application value of three-dimensional power Doppler imaging in diagnosis of carotid artery stenosis in the elderly
Xiuhua CHEN ; Mingxiao WU ; Fajin GUO ; Xiujie HAN ; Chuanyu WANG ; Na MA
Chinese Journal of Geriatrics 2008;27(9):649-652
Objective To evaluate the application value of three-dimensional power Doppler imaging(3D-PDI) in diagnosis of carotid artery stenosis in the elderly. Methods A total of 72 elderly patients with history of hypertension, coronary atheroselerosis, diabetes mellitus or hyperlipidemia were included in the study. The condition of carotid artery stenosis was examined by colour doppler flow imaging (CDFI), 3D-PDI in free-hand mode, and measured by digital subtraction angiography (DSA) as a golden standard in 24 hours. The sensitivity, specificity, positive and negative predictive values were calculated, and all the results were compared with CDFI. Results 3D-PDI directly showed the stereo image, including surface character and exact position of plaque,volume of vessel lumen and spatial distribution of blood flow. Seventy two patients had 85 stenosis of carotid arteries. There was no statistical difference in diameter stenosis rate between CDFI and 3D-PDI [(49.2±0.7)% vs. (52.3±0.3)%,P>0.05], and the area stenosis rate measured by 3D-PDI was significantly lower than by CDFI[(53.24±0.7)% vs. (59.3±0.4)%, P<0.01]. In the diagnosis of stenosis classification, the diagnostic sensitivities of light, mild and severe stenosis were significantly different between CDFI(88.9%,100.0%,100.0%) and 3D-PDI(100.0%,70.4%,58.1%) all(P<0.01). The 3D-PDI was better in diagnostic sensitivity of mild and severe stenosis, but specificity was not better than CDFI. Conclusions 3D-PDI is an easy, convenient method with no-wound and good reproducibility in the diagnosis of carotid artery stenosis. It is more accurate than CDFI and similar to DSA.
6.Clinical efficacy of off-midline closure techniques for treatment of chronic pilonidal sinus
Chinese Journal of Medical Aesthetics and Cosmetology 2022;28(4):320-322
Objective:To evaluate the clinical efficacy of off-midline closure technique in the treatment of chronic pilonidal sinus.Methods:From July 2014 to July 2018, 59 patients suffered from chronic pilonidal sinus treated by off-midline closure were admitted to the Department of Proctology, Linyi Central Hospital, including 34 males and 25 females. According to the size and scope of the chronic pilonidal sinus, the off-midline flap was designed and sutured.Results:In this group of 59 patients, there were 52 cases of primary healing and 7 cases of incision complications, such as partial incision dehiscence and subcutaneous effusion. After follow-up for 2 years, no recurrence was observed. The scar was not obvious after wound healing. The patient was satisfied with the postoperative appearance.Conclusions:Using the off-midline closure technique to treat chronic pilonidal sinus can deviate from the midline to make the suture tension-free and the gluteal groove elevated. It not only effectively reduce the complication rate in patients, but also has high cure rate, low recurrence rate and does not affect appearance.
7.A comparative study of transtibial approach and assisted medial approach for femoral tunnel near-isometric reconstruction of anterior cruciate ligament
Rong FAN ; Zhichao HE ; Chuanyu MA ; Weifeng WU ; Yan ZHANG
Chinese Journal of Orthopaedic Trauma 2022;24(3):267-271
Objective:To compare the location and efficacy of femoral tunnel near-isometric reconstruction of anterior cruciate ligament (ACL) between the transtibial and assisted medial approaches.Methods:The clinical data of 47 patients were retrospectively analyzed who had been admitted by Department of Orthopaedics, The 904 Hospital of PLA for ACL rupture from January 2018 to December 2019. They were divided into 2 groups according to different surgical approaches. In groups A of 21 cases, there were 15 males and 6 females with an age of (29.5 ± 4.8) years and their ACL was reconstructed through the transtibial approach with adjustable Endobutton plate; in group B of 26 cases, there were 18 males and 8 females with an age of (31.2 ± 9.6) years and their ACL was reconstructed through the assisted medial approach with adjustable Endobutton plate. The 2 groups were compared in terms of location of femoral tunnel, Lysholm score and International Knee Documentation Committee (IKDC) score at the last follow-up, and anterior-posterior and rotational stability of the knee joint.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The 47 patients were followed up for 18 to 27 months (average, 22.3 months). As for the center of the inner opening of the femoral tunnel located by the four grid table method, the X-axis loci was 25.6% ± 2.5% and 26.7% ± 1.8% respectively in groups A and B, showing no statistically significant difference ( P>0.05) while the Y-axis loci 19.8% ± 2.0% and 30.6% ± 1.5% respectively in groups A and B, showing a statistically significant difference ( P<0.05). At the last follow-up, the lyholm scores were 90.9 ± 3.4 and 92.4 ± 3.9 and the IKDC scores 89.9 ± 3.5 and 90.2 ± 3.8 respectively in groups A and B, showing no significant difference between the 2 groups ( P>0.05). There was no significant difference either in the results of front drawer test, Lachman test or axial displacement test between the 2 groups ( P>0.05). Conclusion:In femoral tunnel near-isometric reconstruction of ACL, the transtibial approach can result in a tunnel location which is closer to the top of the condyle than the assisted medial approach, but both approaches can lead to satisfactory curative efficacy in the short postoperative period.
8.Age, estimated glomerular filtration rate and ejection fraction score predicts contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease: insight from the TRACK-D study.
Jing LI ; Yi LI ; Xiaozeng WANG ; Shuguang YANG ; Chuanyu GAO ; Zheng ZHANG ; Chengming YANG ; Quanming JING ; Shouli WANG ; Yingyan MA ; Zulu WANG ; Yanchun LIANG ; Yaling HAN
Chinese Medical Journal 2014;127(12):2332-2336
BACKGROUNDThe occurrence of contrast induced acute kidney injury (CIAKI) has a pronounced impact on morbidity and mortality. The aim of the present study was to appraise the diagnostic efficacy of age, estimated glomerular filtration rate (eGFR) and ejection fraction (AGEF) score (age/EF(%)+1 (if eGFR was <60 ml × min(-1)× 1.73 m(-2))) as an predictor of CIAKI in patients with diabetes mellitus (DM) and concomitant chronic kidney disease (CKD).
METHODSThe AGEF score was calculated for 2 998 patients with type 2 DM and concomitant CKD who had undergone coronary/peripheral arterial angiography. CIAKI was defined as an increase in sCr concentration of 0.5 mg/dl (44.2 mmol/L) or 25% above baseline at 72 hours after exposure to the contrast medium. Post hoc analysis was performed by stratifying the rate of CIAKI according to AGEF score tertiles. The diagnostic efficacy of the AGEF score for predicting CIAKI was evaluated with receiver operating characteristic (ROC) analysis.
RESULTSThe AGEF score ranged from 0.49 to 3.09. The AGEF score tertiles were defined as follows: AGEFlow ≤ 0.92 (n = 1 006); 0.92
CONCLUSIONThe AGEF score is effective for stratifying risk of CIAKI in patients with DM and CKD undergoing coronary/peripheral arterial angiography. (Clinical Trial identifier: NCT00786136).
Acute Kidney Injury ; physiopathology ; Contrast Media ; Female ; Glomerular Filtration Rate ; physiology ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Renal Insufficiency, Chronic ; physiopathology