Objective To observe the effect of adjusting high dietary profein intake on nutritional status of peritoneal dialysis (PD) patients. Method Thirty three PD patients whose daily protein intake (DPI) was over 1.2g/(kg? d) were included in study from July, 2005 to November, 2006. A recipe was given by a professional dietitian for every patient to reduce DPI meanwhile maintaining sufficient daily energy intake (DEI). DPI, DEI, serum albumin (ALB), lean body mass(LBM) and subjective global assessment(SGA) and the prevalence of hyperphosphatemia, hyperkalemia and metabolic acidosis were evaluated before and after 3 and 6 mo adjustment. Results At the end of observation, 28 patients were enrolled in the study. Their mean age was 61.37?12.25 yrs, 11 males and 17 females with dialysis period 8.8 mon (1～66 mo). DPI and DEI were significantly decreased during 6 mo (P=0.000). Nobody complained about gastrointestinal symptoms, and the quality and satisfaction of life during the study were not significantly different. Serum Alb at 3 rd month was higher than the start of study (36.22?2.79g/L vs 37.34?3.32 g/L,P

Adolescent ; Child ; Child, Preschool ; Endoscopy ; Esophageal and Gastric Varices ; surgery ; Female ; Humans ; Infant ; Ligation ; Male

Objective To evaluate the safety and efficacy of the photoselective prostate vaporization (PVP) for the patients of benign hyperplasia of prostate (BPH) with oral anti-coagulant.Methods From September 2008 to May 2010,7 cases of BPH with oral anti-coagulant were treated by PVP,with an average age of 74 years.The prothrombin time before the surgery was (13.14 ± 0.15) s.An 100 W Green-light laser source was applied in this study.The prostate volume,operating time,blood loss,catheter indwelling time after the surgery,hospital stay,PVR,Q IPSS score were recorded.Results The mean operating time was (65 ± 22) min without active bleeding or transfusion in this cohort.The haemoglobulin concentration was intact and catheter indwelling time was (22 ± 8) h,while the hospital stay was (2.7 ± 1.2) d.The PVR,Q IPSS score were significantly improved after follow-up of 1 month (P ＜0.01).One case complicated acute urinary retention after operation in this cohort,and the catheter was removed 4 weeks after α-blocker administration.Conclusions PVP is a safe and effective surgical strategy for BPH patients with oral anti-coagulant.However,since there were relatively limited cases enrolled in this study,more randomized controlled clinical trials are needed in the near future.

Objective To study the difference between central and peripheral position of contrast gray-scale imaging in rabbit′s liver.Methods Ultrasound contrast agent(UCA) SonoVue TM ( 0.1 ml/kg) was applied respectively in 8 normal rabbits by intravenous bolus injection.Corresponding parameters of the time-intensity curve: time to enhancement(ET),time to peak intensity(PIT),peak signal intensity(PSI),mean transit time(MTT) and area under the curve(AUC) were measured using low mechanical index contrast gray-scale imaging and Wash-in/Wash-out time intensity curve software.Results There was significant difference of parameters of the time-intensity curve between central position and peripheral position of parenchyma ( P

Objective To study the relationship between doses of ultrasound contrast agent(UCA) and contrast-enhancement effects of gray-scale imaging in rabbit liver. Methods Ultrasound contrast agent SonoVue TM in eight different doses ( 0.02 - 0.16 ml/kg) was applied respectively in five normal rabbits in randomized order as a bolus in a marginal ear vein followed by a 1.5 ml saline flush. Corresponding parameters of the time-intensity curve: time to enhancement(ET),time to peak intensity(PIT),peak signal intensity(PSI),mean transit time(MTT) and area under the curve(AUC) were measured using low mechanical index contrast gray-scale imaging and Wash-in/Wash-out time intensity curve software package. Results Along with an increase of the SonoVue TM dose,the MTT and the AUC increased exponentially,and the ET decreased exponentially. The PSI of portal vein and liver parenchyma increased only in the dose range from 0.02 ml/kg to 0.10 ml/kg ( r = 0.89 and 0.92 ,respectively),and decreased with a further increase of the UCA dose. A possible explanation for this effect is the bubble saturation and attenuation. No significant correlation was found between the UCA dose and the PIT( r = -0.35 and 0.22 ,respectively). Conclusions The parameters of time-intensity curve are influenced intensely by different UCA dose. It is important to grasp the relationship between the UCA doses and contrast-enhancement effects for microcirculatory quantification. The 0.10 ml/kg appears to be the optimal dose for tissue perfusion studying because it significantly improved videointensity and duration of enhancement and did not result in the bubble saturation and attenuation.

Objective To investigate the clinical effect of mosapride combined acupoint massage on diabetic gastroparesis(DGP)in elderly patients with type 2 diabetes.Methods 150 cases of DGP in our hospital from April 2015 to May 2016 were collected and randomly divided into three groups:the conventional treatment group(n=35,in insulin treatment),the control group(n=52,in mosapride treatment),and the experimental group(n=63,in mosapride combined with acupoint massage treatment).All patients received the conventional diabetic therapy.Clinical efficacy,gastric emptying rate and the levels of serum gastrin and fasting blood glucose were observed and compared before versus after treatment among the three groups.Results After treatment,the total effective rate was 92.1% in the experimental group,versus 51.4% and 73.1% in the conventional treatment group and control group respectively,showing a statistically significant difference(P<0.05).There were significant differences in gastric emptying rate,the levels of serum gastrin and fasting blood glucose among the 3 treatment groups before versus after treatment.And gastric emptying rate,the levels of serum gastrin and fasting blood glucose were improved in the experimental groups compared with the conventional treatment and control groups(all P<0.05).The follow-up results showed that the adverse reactions and the recurrence rates were significantly lower in the experimental group than in conventional treatment group and control group(all P<0.05).Conclusions Mosapride combined with acupoint massage in the treatment of diabetic gastroparesis have significant clinical effect,low recurrence rate and high safety,and is worthy of promotion.

Objective:To investigate the relationship between the expression of P16 protein and the clinico-pathology of squamous cell carcinoma(SCC) of buccal mucosa and its precursor lesions. Methods:The immunohistochemical stain against p16 was performed in 30 cases of SCC of buccal mucosa, 32 cases of buccal leukoplakia and buccal lichen planus and 10 cases of normal buccal mucosa. All data were analyzed quantitatively by imag analysis technique. Then, the results were compared with clinico-pathological parameters.Results:The positive expression of P16 protein was found in all normal buccal and hyperplasia mucosa (100.0%), in 9 out of 10 cases of atypical hyperplasia (90.0%), in 12 out of 30 cases of SCC of buccal mucosa (40.0%). The positive expression rate of P16 protein in SCC of buccal mucosa was significantly lower than that in atypical hyperplasia (P

ObjectiveTo evaluate the diagnostic performance of bone SPECT and CT fusion imaging in bone metastases from pediatric neuroblastoma.MethodsTwenty-four pediatric patients with neuroblastoma were included in this retrospective study.All patients underwent planar imaging and SPECT integrated with CT.Lesion visibility,diagnostic certainty and diagnostic performance were evaluated with KolmogorovSmirnov test andx2 test.ResultsLesion visibility of SPECT alone,SPECT integrated with CT were significantly better than that of planar imaging ( both H =69.000,P ＜ 0.05 ).SPECT and CT fusion imaging,SPECT alone both detected five more bone lesions than planar bone imaging (77 vs 72).The diagnostic accuracy of SPECT imaging (62.34％,48/77 )was significantly higher than that of planar imaging (45.45％,35/77; x2 =4.416,P ＜ 0.05 ).The sensitivity,specificity and accuracy of SPECT and CT fusion imaging for diagnosing malignant bone lesions were significantly higher than those of planar imaging:82.35％ (42/51) vs 53.19％ ( 25/47),88.46％ ( 23/26 ) vs 40.00％ ( 10/25 ),84.42％ ( 65/77 ) vs 45.45％ (35/77 ; x2 =12.571,14.016,25.667,all P ＜ 0.01 ).The diagnostic specificity and accuracy of SPECT and CT fusion imaging were significantly higher than those of SPECT alone ( 53.85％,14/26 ;62.34％,48/77) (x2 =7.589,9.606,both P ＜0.01 ).However,there was no significant difference of sensitivity between the two methods (x2 =2.942,P ＞ 0.05 ).Diagnostic certainty by SPECT and CT fusion imaging was significantly higher than that by SPECT alone ( H =28.000,P ＜ 0.05 ) and by planar imaging (H =21.000,P ＜ 0.05).ConclusionSPECT and CT fusion imaging can detect more bone lesions in patients with pediatric neuroblastoma.It is helpful for diagnosing bone metastases from pediatric neuroblastoma.

Objective To observe and analyze the therapeutic effect of focal uterine adenomyosis treated with percutaneous microwave ablation by contrast-enhanced ultrasound and dynamic contrast enhanced MRI (DCE-MRI).Methods From January 2013 to July 2016,42 patients with focal uterine adenomyosis voluntarily underwent percutaneous microwave ablation in the tumor hospital of Liaocheng.Contrast-enhanced ultrasound and DCE-MRI were performed before and after percutaneous microwave ablation.The therapeutic effects of percutaneous microwave ablation in treatment of uterine adenomyosis lesions were observed.Results After percutaneous microwave ablation of the 42 cases,the ablated zone showed no enhancement with contrast-enhanced ultrasound and DCE-MRI.Contrast-enhanced ultrasound showed that the volume and ablation rate of ablated zone were (49.0±29.5) cm3 and (91.6± 7.1)％,and that of DCE-MRI were (49.4 ± 29.9)cm3 and (91.9 ± 6.7)％,respectively.The results showed that percutaneous microwave ablation could cure focal uterine adenomyosis at the rate over 90％.Contrast-enhanced ultrasoundand DCE-MRI are in accordance in observing the ablation rate.Conclusions Contrast-enhanced ultrasound can accurately show the ablation rate of focal uterine adenomyosis treated with percutaneous microwave ablation,which is quite consistent with DCE-MRI.Contrast-enhanced ultrasound has its advantages such as identifying the lesions which need immiedately supplemental ablation.

Objective To investigate the value of modified loop ileostomy in laparoscopic low and superlow radical resection of the rectal cancer with reservation of anus.Methods The clinical data of 108 patients who received laparoscopic low and super-low radical resection of rectal cancer with preservation of anus at the Subei Hospital of Jiangsu Province from January 2010 to June 2012 were retrospectively analyzed.Fifty-three patients who received preventive ileostomy were in the ileostomy group,and 55 patients who did not receive preventive ileostomy were in the non-ileostomy group.The operation,incidence of complication and follow-up of the 2 groups were analyzed.All data were analyzed using the t test,chi-square text or Fisher exact test.Results The operation time and blood loss were (185 ± 14)minutes and (31 ± 26)ml in the ileostomy group,and (154 ± 12)minutes and (28 ± 19)ml in the non-ileostomy group,with no significant difference between the 2 groups (t =2.34,1.82,P ＞ 0.05).The time to first flatus,time to liquid diet intake,time to pelvic drainage tube removal,duration of hospital stay,hospital costs were (1.1 ± 0.3) days,(1.1 ± 0.2) days,(5.2 ± 1.0) days,(7.2 ± 1.4) days,(3.0 ± 0.2) ×104 yuan in the ileostomy group,and (4.2 ± 0.6) days,(4.3 ± 0.6) days,(8.4 ± 3.9) days,(12.9 ±4.4)days,(3.8 ±0.7) × 104 yuan in the non-ileostomy group,with significant differences between the 2 groups (t =7.25,28.12,15.34,34.01,7.83,P ＜ 0.05).The incidences of postoperative complications and anastomotic fistula were 5.7％ (3/53) and 0 in the ileostomy group,and 21.8％ (12/55) and 12.7％ (7/55) in the non-ileostomy group,with significant differences between the 2 groups (P ＜ 0.05).Conclusion Modified loop ileostomy in laparoscopic low and super-low radical resection of rectal cancer can effectively reduce the incidence of anastomotic fistula,and helps the recovery of patients.