Objective To explore the application of ultrasonography combined with hysteroscopy for the diagnosis of dated uterine false passage. Methods From May 2012 to May 2013, a total of 3437 cases were examined in the center by ultrasonic monitoring combined with hysteroscopic examinations.Dated uterine false passage was found in 4 cases.Under the guidance of ultrasonography, the hysteroscope was introduced into the uterine cavity.The ultrasonic probe was put at the site above the pubic symphysis for comprehensive examinations, with uterine distention fluid as reference. Results There were 2 cases of uterine anteversion and 2 cases of retroversion.There were 1 case of intracervical mouth stenosis, 1 case of intracervical mouth adhesion, and no intracervical mouth stricture or adhesion in 2 cases.The uterine false passage was located in the anterior wall in 2 cases and located in the back wall in 2 cases.The distance to serosal surface was about 3 mm at the thinnest place.The uterine false passage was 3-4 cm in depth. Conclusion Ultrasound monitoring combined with hysteroscopic examination can determine the part of the uterine endometrium line, improve the accuracy of diagnosis and treatment of intrauterine lesions.

The paper analyzes the challenge of big data environment to the traditional medical information services,presents the practical significance and basis of constructing the medical information service platform,introduces the construction objectives,architecture,function feature of the platform,describes the medical information service mode based on the digital platform,including medical information resource services,intelligence study services and health decision-making support services,etc.

Several reconstruction techniques are available after gastrectomy. Roux-en-Y reconstruction following distal gastrectomy is the reference in terms of long-term functional and endoscopic outcomes. It is the preferred reconstruction for benign lesions and early gastric cancer. In patients with advanced gastric cancer, BillrothII (reconstruction is an acceptable alternative. After total gastrectomy, Roux-en-Y reconstruction is the simplest solution, with satisfactory functional outcome. Addition of a jejunal reservoir seems to improve long-term outcome after total gastrectomy and could be of benefit to patients with good prognosis. After distal or total gastrectomy, hand-sewn anastomoses should be preferred because of lower costs. Mechanical sutures can facilitate transhiatal esophagojejunostomy. After proximal gastrectomy, esophago-gastric anastomosis is the basic reconstruction method. Gastric remnant is made into gastric tube in the operation. The effect of pyloroplasty remains controversial, and further study is needed to improve the quality of life after operation.
Anastomosis, Roux-en-Y ; methods ; Gastrectomy ; Gastroenterostomy ; methods ; Humans ; Reconstructive Surgical Procedures ; methods ; Stomach Neoplasms ; surgery

Combined Modality Therapy ; Humans ; Stomach Neoplasms ; therapy

Humans ; Infarction, Middle Cerebral Artery/surgery* ; Thrombectomy ; Thrombosis/etiology* ; Stents/adverse effects* ; Treatment Outcome

Humans ; Infant, Newborn ; Lung Diseases ; Pulmonary Artery ; Thrombosis

Radiomics utilizes the high-throughput extraction of large amounts of quantitative features from radiographic images,giving a comprehensive quantification of tumor phenotype.Thus it can provide complementary and interchangeable information for clinical usage,such as differentiating malignant nodules from benign ones,predicting response to treatment,identifying lymph node metastasis,improving individualized treatment selection and monitoring.The advantages of radiomics give it great potential in precise treatment.But much work needs to be done before it could be used in practice.It is imperative that a standard research procedure is needed to verify its reliability and clinical value via multi-central prospective clinical trials.

Objective To discuss the value of 256 spiral CT dynamic volume scanning in the diagnosis of moyamoya disease.Methods Twenty-three patients with moyamoya disease undergoing 256 spiral CT dynamic volume scanning (moyamoya group) were selected,and 18 patients having cerebrovascular disease symptoms,but the brain artery without stenosis (control group) were also selected.The volume reconstruction (VR),maximum intensity projection (MIP) and cerebral CT perfusion imaging was displayed.The cerebral CT perfusion imaging parameters of anterior,middle,posterior cerebral artery were measured and analyzed.Results VR,MIP could well reproduce lesion location,degree of stenosis and skull base abnormal vascular network change.Compared with control group,the cerebral blood volume (CBV) was increased [(8.46 ±0.91) ml/100 g vs.(2.92 ±0.72) ml/100 g],time to peak (TTP) was increased [(30.27 ±5.02) s vs.(24.83 ±4.07) s] in anterior cerebral artery,and there was significant difference (P ＜ 0.01),but there was no significant difference in the cerebral blood flow (CBF),the mean transit time (MTT)(P ＞ 0.05).Compared with control group,CBV was increased [(8.06 ± 1.05) ml/100 g vs.(6.08 ± 0.56) ml/100 g],MTT,TTP was increased [(6.34 ± 1.01) s vs.(3.83 ± 0.83) s,(32.06 ± 2.55) s vs.(25.83 ± 2.34) s] in middle cerebral artery,and there was significant difference (P＜ 0.01),but there was no significant difference in CBF (P ＞ 0.05).Compared with control group,there was no significant difference in the cerebral CT perfusion imaging parameters of posterior cerebral artery (P ＞0.05).Conclusion 256 spiral CT dynamic volume scanning can be combined with morphology and function imagings,and has important guiding significance for diagnosis of moyamoya disease.

Objective To evaluate the possibility and efficiency of nanoparticles as a new vector in vascular endothelial growth factor (VEGF) gene transfection. Methods Nanoparticle-VEGF (Np/VEGF)complex was prepared with poly (D, L-lactide-co-glycolide) (PLGA) loading VEGF165 gene using the multiple emulsion (w/o/w) technique. The envelopment efficiency and size of the complex were determined. Rat myocardial cells were cultured in vitro, and the Np/VEGF was transfected into the cultured myocardial cells. Then RT-PCR and ELISA were used to evaluate whether the Np/VEGF increased the level of gene expression. Four New Zealand rabbits were used, the suspension of Np/VEGF was injected into myocardial tissue of rabbits after thoracotomy. 96h after the operation, the tissue sections of the implant sites were observed with transmission electron microscope (TEM) to determine the process of nanoparticles as vectors for gene transfer to cardiac myocytes. Results The envelopment efficiency and size of the Np/VEGF complex thus prepared were 1.87% and 25-300nm respectively. RT-PCR and ELISA showed that VEGF gene could be successfully transfected into myocardial cells by nanoparticle, and NP/VEGF significantly enhanced gene transfection efficiency, and it was more effective than plasmid. 96h after the operation, a great number of nanoparticles were observed in myocardial cytoplasm and nucleus with TEM, and many nanoparticles began to dissolve and degrade, suggesting that the DNA was released slowly from the nanoparticles localized in the cytoplasmic compartment, and was then transferred into the nucleus. Conclusions NP/VEGF can act as a vector to transfect VEGF gene in vitro and in vivo, it significantly enhanced gene transfection efficiency, and it was more effective than plasmid.

Objective: To determine the changes of upper airway morphology induced by mandible position from central relation to advancement position in patients with obstructive sleep apnea syndrome. Methods: Nineteen patients (17 males and 2 females) suffering from obstructive sleep apnea syndrome were confirmed with polysomnography. Occlusal wax record was made with mandible in advancement position. Helical computed tomography was performed on each patient in central relation and mandibular advancement position with wax record in situ respectively. On each slice, anteroposterior and transverse diameters were obtained. Airway shape was expressed as the anteroposterior/transverse (AP/T) diameter ratio. Paired samples t test was employed to compare the measurements. Results: With mandibular advancement, average and minimal diameters of glossopharynx and hypopharynx were increased significantly. Compared with it, the change of transverse diameter was more prominent. All segments of upper airway were increased significantly except hypophaynx laterally. Moreover, the change of velopharynx shape was observed on axial planes. Ellipse with transversal long axis became more compressed. Conclusion: Upper airway morphology of all segments was influenced by mandibular advancement whether in the sagittal or transverse plane of space, or airway shape. Not only anatomic connection but also regulation of the nerve system and other still unknown mechanism make contribution to the changes of upper airway morphology in patients with obstructive sleep apnea syndrome. The changes of upper airway morphology above mentioned constitute the rationale of treatment of obstructive sleep apnea syndrome with oral appliances.