Objective To assess the value of three-dimensional contrast-enhanced ultrasonography (3D-CEUS) in evaluation of hepatic arteries variants.Methods Both two-dimensional contrast-enhanced ultrasonography (2D-CEUS) and 3D-CEUS were used to assess 30 patients including living donor candidates and patients with upper abdomen tumors.The reference standard was operation or CTA or DSA or MRA,and the accuracy for detecting hepatic artery variants provided by the two methods was evaluated.Arterial anatomic types were defined by using Michels classification.Results The total accuracy for detecting hepatic artery anatomy types by 2D-CEUS was 40.0% (12/30),while 83.3% (25/30) by 2D-CEUS.For convention anatomy types the accuracy on 2D-CEUS and 3D-CEUS were 40.9%(9/22)and 90.9%(20/22),respectively.The difference was statistically significant (P<0.05).For anatomy variants types the accuracy on 2D-CEUS and 3D-CEUS were 37.5%(3/8)and 62.5%(5/8),respectively.No significant difference between these two methods was observed.Conclusion 3D-CEUS was a new method in diagnosis of hepatic arteries anatomy types with practical clinical value in evaluation of the living liver donors.

Objective To assess the feasibility of three-dimensional contrast-enhanced ultrasonic cholangiography(3D-CEUSC) in cadaver liver.Methods The 3D-CEUSC was performed in 6 cases of cadaver liver.Image quality of 3D-CEUSC was evaluated.The visualization of branching orders,the degree of visibility and coincidence of morphous were compared with those of cholangiagraphy using fluoroscopy.Results The imaging quality of 3D-CEUSC was inferior to that of cholangiography with significant difference.The three-dimensional biliary tree structures were visualized in all 6 3D-CEUSC.The maximum visualization of branching orders in 3D-CEUSC was (3.67±0.52),which was equal to the results(4.00±0.63)by cholangiography (P=0.465).The degrees of visibility of biliary tree were equivalent with those by cholangiography in the first and second order with significant difference.The coincidence of morphous was excellent compared the images of 3D-CEUSC with direct X-ray cholangiography.Conclusion 3D-CEUSC is a new technique as a useful supplement to cholangiography in evaluation of biliary anatomy and variation before graft harvesting in LDLT.

Objective: To learn the awareness of the Three Level Social-psychological Service in Zhejiang Province and its influencing factors, so as to provide the basis for promoting the construction of social-psychological service system. Methods: The counties (cities, districts) in Zhejiang Province were divided into three levels: high, medium and low, according to economic development. The residents are selected by multistage stratified random sampling method. A questionnaire survey was conducted to collect the general information of residents and their awareness of the Three Level Social-psychological Service.The influencing factors for the awareness were analyzed by multivariate logistic regression model. Results : Of 7 114 questionnaires sent out, 6 577 valid ones were recovered, with the response rate of 92.45%. The overall awareness rates of the Three Level Social-psychological Service and service sites was 63.02% and 59.91%, respectively. The multivariate logistic regression analysis showed that the age of 40-<50 years ( OR=1.376, 95%CI: 1.077-1.758 ), permanent residence ( OR=1.474, 95%CI: 1.319-1.647 ), being the national pilots ( OR=1.200, 95%CI: 1.079-1.334 ) and having the experience of seeking mental health services before 2018 (OR=1.323, 95%CI: 1.191-1.469) were the influencing factors for the awareness of the Three Level Social-psychological Service; under 50 years old ( OR: 0.610-0.768, 95%CI: 0.423-0.991 ), permanent residence ( OR=1.571, 95%CI: 1.407-1.755 ), being the national pilots ( OR=1.368, 95%CI: 1.232-1.519 ) and having the experience of seeking mental health services before 2018 ( OR=0.733, 95%CI: 0.661-0.812 ) were the influencing factors for the awareness of the Three Level Social-psychological Service sites. Conclusions It is necessary to improve the awareness of the Three Level Social-psychological Service among Zhejiang residents. Age, permanent residence, being the national pilots, seeking mental health service experience before 2018 are associated with the awareness of the Three Level Social-psychological Service.

Objective To explore a useful nursing method to enhance the feasibility and safety for outpatients with renopuncture biopsy. Methods 352 cases of renopuncture biopsy with the guiding of ultrasound (GE-Logiq5) received intensive nursing before and after operation. The effects of renopuncture and the complication were observed and compared. Results The successful rate of renal biopsy was 100%. However, there were 2 cases appeared the symptom of hematuria, 1 case appeared the symptom of lumbago, and 35% appeared the symptom of hematoma. Most of hematoma were minor less than 2cm so there were no serious syndromes happened. Conclusions Intensive observation and nursing are very important for the safety of outpatients with renopuncture biopsy.

OBJECTIVETo investigate the value of contrast-enhanced ultrasound in the differential diagnosis of solid focal lesions of pancreas (s-FLPs).

METHODSWe retrospectively analyzed the clinical data of 56 s-FLPs examined with contrast agent combined with low mechanical indicators contrast-enhanced ultrasound.

RESULTSThe surrounding pancreas parenchyma enhancement time, lesion enhancement time, and peak enhancement time between different groups of s-FLPs had no significant differences (P > 0.05), while the beginning to peak enhancement time showed significant difference (P < 0.05). When using the enhancement speed as a diagnostic indicator to differentiate pancreatic carcinoma from tumor-like pancreatitis, the sensitivity, specificity, and accuracy were 90.5%, 71.4%, and 85.7% for pancreatic carcinoma and 75.0%, 91.7%, and 89.3% for tumor-like pancreatitis. When using the enhancement pattern as a diagnosis indicator to differentiate pancreatic carcinoma from tumor-like pancreatitis, the sensitivity, specificity, and accuracy were 85.7%, 78.6%, and 83.9% for pancreatic carcinoma and 75.0%, 100%, and 94.6% for tumor-like pancreatitis. When different indicators were combined, enhancement pattern and enhancement speed showed the best diagnostic results; however, the Youden index was not improved.

CONCLUSIONSDifferent s-FLPs show different enhancement findings on contrast-enhanced ultrasound. The enhancement pattern and enhancement speed are the most useful diagnostic indicators.

Diagnosis, Differential ; Humans ; Pancreas ; diagnostic imaging ; Pancreatic Neoplasms ; diagnostic imaging ; Pancreatitis ; diagnostic imaging ; Retrospective Studies ; Ultrasonography

Objective To investigate the prevalence and associated risk factors of hypertension in Songnan community so as to provide evidence for the early prevention of hypertension.Methods Cluster sampling was employed,and questionnaire survey was performed in 10 185 residents aged above 40 years in Songnan community of Baoshan District.The questionnaires involved with hypertension and associated risk factors.Results The prevalence of hypertension was 49.9% in Songnan community of Baoshan District,and that of men was significantly higher than that of women(53.7% vs 47.3%)(P

OBJECTIVETo evaluate the clinical value of high frequency ultrasound in diagnosing peripheral nerve diseases (PNDs).

METHODSFrom January 2003 to December 2006, 64 cases of PNDs were analyzed retrospectively. The ultrasound diagnosis was compared with the operative and pathological diagnosis.

RESULTSBased on the operative and histopathological results, in 38 patients with trauma or entrapment, 38 among 45 traumatic nerves were rightly diagnosed by ultrasound. The coincidence rate was 84.4%. In 26 patients with original peripheral nerve tumors (PNTs), including 20 neurilemmomas, 4 neurofibromas and 2 malignant neurilemmomas, 16 cases were diagnosed by ultrasound with a coincidence rate of 61.5%. The coincidence rates in limbs and trunk were 86.7% (13/15) and 27.3% (3/11) respectively.

CONCLUSIONSThe study suggests that high frequency ultrasound can locate peripheral nerve trauma precisely, assess the impair degree correctly and provide useful information for clinic diagnosis. The high frequency ultrasound brings better diagnosis outcome in limbs nerve tumors than in trunk.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Male ; Middle Aged ; Peripheral Nerve Injuries ; Peripheral Nervous System Diseases ; diagnostic imaging ; Retrospective Studies ; Trauma, Nervous System ; diagnostic imaging ; Ultrasonography

Interactions among the nervous, the endocrine and the immune systems enable the gut to respond to the dietary products, pathogens and microbiota, which maintains the homeostasis of the body. However, dysbiosis may induce or aggravate the gastrointestinal (GI) and extra-GI diseases through changing the activities of enteric nervous system (ENS), enteroendocrine cells and enteric immune cells. Here we review recent advances in the understandings on how intestinal flora may impact the enteric neuro-endocrine-immune system in the gut, thereby contributing to the regulation of pathophysiological processes.
Enteric Nervous System ; Gastrointestinal Diseases ; Gastrointestinal Microbiome ; Humans ; Immune System

CD4-Positive T-Lymphocytes ; Cell Differentiation ; T-Lymphocyte Subsets ; T-Lymphocytes, Regulatory

Non-obstructive azoospermia (NOA), which is defined as the absence of spermatozoa in the ejaculate secondary to impaired spermatogenesis within the testis, may be caused by a variety of etiologies, including varicocele-induced testicular damage, cryptorchidism, prior testicular torsion, post-pubertal mumps orchitis, gonadotoxic effects from medications, genetic abnormalities, chemotherapy/radiation, and other unknown causes currently classified as idiopathic (Cocuzza et al., 2013). The microdissection testicular sperm extraction (micro-TESE) technique involves a meticulous microsurgical exploration of the testicular parenchyma to identify and selectively extract larger seminiferous tubules that carry a higher probability of complete spermatogenesis (Schlegel, 1999). The Cornell group evaluated the efficacy of micro-TESE in 152 NOA patients with an associated history of cryptorchidism. In their series, spermatozoa were successfully retrieved in 116/181 attempts (64%), and the resulting pregnancy rate was 50% with a delivery rate of 38% (Dabaja and Schlegel, 2013). Franco et al. (2016) described a stepwise micro-TESE approach in NOA patients, which was considered to reduce the cost, time, and effort associated with the surgery. Alrabeeah et al. (2016) further reported that a mini-incision micro-TESE, carried through a 1-cm equatorial testicular incision, can be useful for micro-TESE candidates, particularly in patients with cryptozoospermia. We conducted a retrospective study of 20 consecutive NOA patients with a history of orchidopexy from May 2015 to March 2017.
Adult ; Azoospermia/surgery* ; Humans ; Male ; Microdissection/methods* ; Middle Aged ; Orchiopexy ; Retrospective Studies ; Sperm Retrieval