1.Pathological microstructure and ultrastructure changes of liver fibrosis in patients with schistosomiasis liver fibrosis
Hongjian ZHAO ; Yi ZHUGE ; Likang LUO ; Deling ZU
Chinese Journal of Endemiology 2015;34(2):109-111
Objective To explore the pathological changes of liver fibrosis of patients with schistosomiasis liver fibrosis.Methods Between January 2003 and January 2009,microstructure retrospective observation of liver biopsy pathological paraffin specimens by optical microscope was carried out in 9 cases of patients with schistosomiasis liver fibrosis in Quzhou people's hospital internal medicine.Then those paraffin blocks were changed to resin embedding blocks and superfine slices were made.Ultrastructure observation by electronic microscope was carried out.Results Visible fibrous scar formation and fiber calcified nodule eggs in microscopic structure of liver tissue in 9 cases of patients with schistosomiasis liver fibrosis were observed.Ultrastructural observation of the 9 cases of patients with schistosomiasis liver fibrosis showed that most of the liver cell profile was clear,liver cell nucleus gap expanded,the number of rough endoplasmic reticulum decreased,swollen mitochondria crest occurred,collagen deposited around hepatic sinus and surroundings and collagen fiber bundle around small veins extended to hepatic lobule and surroundings,and calcified nodule eggs were not easy to find.Conclusions Under an electron microscope,diseased tissue cells can be observed at subcellular level or organelle level,which provides more insight into the pathology of schistosomiasis liver fibrosis.Calcified egg nodules are easily found by an optical microscope other than an electron microscopy.The two can complement each other.
2.Evaluation of intestinal wall thickness measurement with endoscopic ultrasonography for Crohn disease activity
Hongxuan CHEN ; Shanyu QIN ; Haixing JIANG ; Wei LUO ; Hongjian NING ; Donghong LU ; Lin TAO ; Sibiao SU
Chinese Journal of Digestive Endoscopy 2017;34(6):400-404
Objective To evaluate measurement of the submucosal thickness with endoscopic ultrasonography (EUS) for activity of Crohn disease (CD).Methods Ten patients with active stage of CD and 10 healthy controls (HC) underwent EUS.Simple endoscopic score for Crohn disease(SES-CD)and submucosal thickness at the most severe lesions were measured and recorded.Submucosal thickness of the same region in CD patients were measured at remissive stage.In order to analyze the relationship between submucosal thickness and the stage of CD, submucosal thickness were compared among patients at active stage of CD, remissive stage of CD and HC.And the cut-off value of submucosal thickness was calculated to diagnose the stage of CD.Results The mean submucosal thicknesses of active stage and remissive stage of CD were 6.48±1.95 mm and 2.47±1.08 mm,respectively (P<0.01).The correlation analysis showed that submucosal thickness had a positive correlation with Crohn disease activity index(CDAI)(r=0.708,P<0.01) and SES-CD(r=0.807,P<0.01).Receiver operating characteristic curve analysis was used for 10 cases of CD patients and the area under the curve was 0.985(P<0.01).The cut-off value of submucosal thickness to diagnose active stage of CD was 3.85 mm, and the sensitivity and specificity reached 100% and 90% respectively.The Youden index was 0.9.Conclusion Measurement of gastrointestinal submucosal thickness by EUS could contribute to evaluate the stage of CD and to guide clinical treatment.
3.Determination of femoral anatomic axis in robot-assisted surgery of total knee replacement.
Hongjian LIU ; Yi LUO ; Yuncai LIU
Journal of Biomedical Engineering 2006;23(4):873-877
Determination of femoral anatomic axis plays an important role in robot-assisted surgery of total knee replacement. In traditional total knee replacement surgery, the axis is obtained by inserting a rod into femoral lumen. However, in the robot-assisted total knee replacement based on CT model. the femoral anatomic axis must be determined preoperatively. Because the lengths in femurs are quite different in different patients, besides noises, the upper segment and lower segment of the femur influence the design of the axis greatly. Traditionally, the femoral anatomic axis is obtained by using the least-squares method directly. However, this method is easily disturbed by noise. To avoid the noise disturbance of CT data, the least median of squares method is used to fit the femoral anatomic axis for its characteristic of robust regression. The least median squares method eliminates the disadvantage brought by the method of least squares. In finding the best-fit line, genetic algorithms are used in the paper. In our experiment, we use the proposed method to fit the femoral anatomic axis and obtain an excellent result.
Algorithms
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Arthroplasty, Replacement, Knee
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methods
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Femur
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anatomy & histology
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diagnostic imaging
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surgery
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Humans
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Robotics
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Surgery, Computer-Assisted
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instrumentation
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methods
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Tomography, X-Ray Computed
4.Efficacy of EUS-guided ethanol ablation in the treatment of insulinoma
Shanyu QIN ; Zhiling LIU ; Haixing JIANG ; Wei LUO ; Bangli HU ; Hongjian NING ; Lin TAO ; Sibiao SU ; Fengyan QIN
Chinese Journal of Digestive Endoscopy 2016;33(2):72-76
Objective To evaluate the safety and efficacy of endoscopic ultrasonography(EUS) guided ethanol ablation in patients with insulinoma. Methods The data of 10 patients with insulinoma trea-ted at the First Affiliated Hospital of Guangxi Medical University from December 2013 to January 2015 were prospectively analyzed. Results The patients were given EUS-guided ethanol ablation with dose of 0. 10 to 2. 00 ml(average 0. 70 ± 0. 62 ml)in pancreatic lesions for 15 times. No complications were observed dur-ing and after the procedure. The blood glucose improved after the procedure[4. 8(3. 9-5. 5)mmol/ L VS 2. 4 (1. 9-2. 5)mmol/ L,P < 0. 05]and the serum insulin level significantly decreased[83. 7(40. 1-143. 5) pmol/ L VS 177. 3(66. 5-200. 6)pmol/ L,P<0. 05]. The average hospital stay was(4. 3±1. 5)days. The patients were followed up for 6-12 months. EUS indicated that the echo of pancreatic lesions changed from high to low. CE-EUS revealed low enhancement and lack of blood supply. Conclusion EUS-guided ethanol ablation may become a promising minimally invasive treatment for insulinoma because of its safety,efficacy and low price. Trail registration Clinical Trial.gov,NCT02121366.
5.CT findings of invasive mucinous adenocarcinoma of the lung
Hongjian LUO ; Shiguang LI ; Wei YANG ; Yiyun LUO
Chinese Journal of Postgraduates of Medicine 2017;40(11):1020-1024
Objective To analyze the CT findings of invasive mucinous adenocarcinoma of the lung.Methods The CT findings of 7 patients with invasive mucinous adenocarcinoma of the lung were retrospectively analyzed. Results Six cases manifested isolated pulmonary nodules or masses, among which circular/round shape was in 6 cases,clear tumor-lung parenchyma interface was in 6 cases,lobular sign was in 5 cases,specular sign was in 6 cases,calcifications was in 3 cases,angiogram sign of contrast enhancement was in 4 cases, and the CT value was close to the liquid density in 6 cases. One case showed consolidation of lung with multiple nodules or mass, and the lesions had angiographic signs calcification, unenhanced area with water density as well. The CT findings of angiography signs, calcification and consolidation of regional focal liquid opacity had significance for the diagnosis.One case was misdiagnosed as tuberculosis and 1 case as hamartomas. Factors which caused misdiagnosis were irregularly shaped calcifications and angiographic signs in lesion, and the enhanced CT value was less than 20 HU. Conclusions The invasive mucinous adenocarcinoma of the lung has characteristic CT findings. In addition to the malignant tumor features. When plain CT scan finds the watery density, calcifications and angiographic signs in the lesion, the invasive mucinous adenocarcinoma of the lung should be considered.The enhanced CT scan shows no enhancement or enhanced value less than 20 HU is also the characteristic of invasive mucinous adenocarcinoma of the lung. MRI check will help us to improve the diagnostic accuracy.
6.Clinical analysis of 330 patients with primry aldosteronism
Nanfang LI ; Hongjian LI ; Hongmei WANG ; Xinling WANG ; Feiya ZU ; Guijuan CHANG ; Keming ZHOU ; Qin LUO ; Menghui WANG ; Junli HU ; Lei WANG
Chinese Journal of Endocrinology and Metabolism 2011;27(9):752-754
The clinical data of 330 patients with primary aldosteronism (PA) from January 2006 to March 2010 were retrospectively analyzed. The prevalence of 1, 2, and 3 stage hypertension in these subjects was 3.64%,20. 91%, and 75.45 %, respectively. Of all PA patients, 89.09% were young adults and 81.82% were overweight or obese. There was a marked preponderance of male patients in the overweight or obese group ( P<0. 01 ). The incidence of hypokalemia was 32. 12%. The concentration of serum potassium was not associated with the disease course. Logistic regression showed that the concentration of plasma aldosterone was an independent risk factor of hypokalemia in PA patients( P<0. 01 ). 79. 09% PA patients presented the plasma aldosterone level over 12 ng/dl and the renin activity level of less than 1 ng · ml-1 · h-1. The aldosterone-to-rennin activity ratio was >20 in 94.24% of the patients with PA.
7.Diagnostic value of narrow-band imaging combined with endoscopic ultrasonography for ampullary tumors
Shuo TANG ; Shanyu QIN ; Haixing JIANG ; Wei LUO ; Donghong LU ; Lin TAO ; Hongjian NING ; Sibiao SU
Chinese Journal of Digestive Endoscopy 2019;36(2):108-112
Objective To study the diagnostic value of narrow-band imaging ( NBI) combined with endoscopic ultrasonography ( EUS) for ampullary tumors. Methods A total of 21 patients suspected with ampullary lesions by imaging or endoscopic examination from December 2015 to March 2017 were enrolled in this prospective study. All patients underwent NBI and EUS, and 20 patients underwent biopsy. The type of ampullary tumor was predicted by preoperative examination, and appropriate treatment methods were chosen. The final diagnosis was confirmed by biopsy, surgical pathology, and clinical follow-up for more than 6 months. The accuracy of NBI combined with EUS and biopsy in diagnosis of ampullary malignant tumors was calculated according to the gold standard. The Chi-square test was used to compare diagnostic accuracies. Results The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of NBI combined with EUS in diagnosis of ampullary malignancies were 94. 1% (16/17), 100. 0% (4/4), 95. 2% (20/21), 100. 0% (16/16), and 80. 0% (4/5), respectively. The corresponding indicators of preoperative biopsy were 41. 2% ( 7/17) , 100. 0% ( 3/3) , 50. 0% ( 10/20) , 100. 0% ( 7/7) , and 23. 1%( 3/13) , respectively. The accuracy of NBI combined with EUS in diagnosing ampullary malignant tumor was significantly higher compared with preoperative biopsy ( P=0. 004) . Conclusion NBI combined with EUS can more accurately predict benign or malignant ampullary tumor, and better guide the choice of surgical methods compared with preoperative biopsy.
8.Overlap syndrome: a case report of extensive chronic graft-versus-host disease and literature review
Yanxia ZHOU ; Shenghui LUO ; Weixuan QIN ; Hongjian YE ; Ying WANG ; Wenfang CHEN ; Zhijian LI ; Wei CHEN ; Xin WANG
Chinese Journal of Nephrology 2023;39(11):851-857
The paper reported a case of a young male patient, with graft-versus-host disease (GVHD) multi-organ involvement lesions after allo-hematopoietic stem cell transplantation. The patient had diverse clinical manifestations, and overlapping acute and chronic disease processes. Acute GVHD were mainly hyperbilirubinemia, with or without elevated transaminase, bloody watery stools; chronic GVHD were highlighted by extensive skin depigmentation, oral mucosal ulcer, sick nails, etc., and chronic signs, such as membranous nephropathy, polyserositis and pulmonary restrictive ventilatory insufficiency. The diagnosis of chronic GVHD mainly relies on medical history combined with clinical manifestations, and it's needed to exclude infections, drugs and tumors. Besides, the rate of missed diagnosis and misdiagnose is high, and it requires multidisciplinary diagnosis and treatment. Combined with the literature review, it indicates that there is a greater risk of GVHD in the male recipient with female donor, and peripheral blood stem cell transplant patients have a higher incidence than bone marrow transplant patients after hematopoietic stem cell transplantation, but the effect of the graft-versus-leukemia exists. Currently, glucocorticoids therapy with or without calcineurin inhibitors are the first-line treatment for GVHD, but the overall prognosis is poor.
9.Application and economic effects of digital three-dimensional reconstruction in hip hemiarthroplasty for intertrochanteric femoral fractures in the elderly
Peng LI ; Xiaosong HAN ; Bingyan XIANG ; Yingyi HE ; Kun HUANG ; Li LIU ; Hongjian LUO ; Shiqiang RUAN
Chinese Journal of Tissue Engineering Research 2024;28(18):2814-2818
BACKGROUND:Digital three-dimensional reconstruction technology is gradually applied to orthopedic diseases with the advantages of visualization,accuracy and non-invasiveness,but there is less evidence-based support for its use in artificial hip hemiarthroplasty for intertrochanteric fractures of the femur in the elderly. OBJECTIVE:To investigate the application value and economic effects of digital three-dimensional reconstruction techniques in artificial hip hemiarthroplasty of intertrochanteric fractures of the femur in the elderly. METHODS:One hundred and thirty elderly patients with intertrochanteric femur fractures admitted to Zunyi First People's Hospital from January 2019 to December 2022 were selected and randomly divided into a control group(n=65)and an observation group(n=65).Artificial hip hemiarthroplasty was performed in both groups.The control group adopted the film template measurement method for manual preoperative planning while the observation group adopted a digital three-dimensional reconstruction technique.Preoperative planning and intraoperative actual application of prosthesis compliance rate,fibrinogen,D-dimer,bilateral femoral eccentric distance difference,bilateral lower limb length difference,Harris hip function score,visual analog scale score,excellent and good rate of hip function,complications,and hospitalization cost were observed in both groups. RESULTS AND CONCLUSION:(1)The proportion of acetabular side and femoral side prosthesis in grade 0(fully compliant)was higher in the observation group than that in the control group(P<0.05).(2)Fibrinogen and D-dimer levels in the observation group were lower than those in the control group 3 days after surgery(P<0.05).(3)The difference in bilateral femoral eccentric distance and the difference in bilateral lower limb length in the observation group were smaller than those in the control group immediately after surgery(P<0.05).The differences in Harris and visual analog scale scores were not significantly different between the two groups preoperatively,6 and 12 months postoperatively(P>0.05).There was no significant difference in excellent and good rate of hip function between the two groups 12 months postoperatively(P>0.05).(4)There was no significant difference in the complication rate between the two groups(P>0.05).The hospitalization cost of the observation group was higher than that of the control group(P<0.05).(5)It is indicated that digital three-dimensional reconstruction technology applied in artificial hip hemiarthroplasty of intertrochanteric femoral fracture in the elderly can not only accurately determine the prosthesis type before surgery,but also accurately reconstruct the bilateral lower limbs offline,but its hospitalization cost is high.
10.Expert consensus on rehabilitation strategies for traumatic spinal cord injury
Liehu CAO ; Feng NIU ; Wencai ZHANG ; Qiang YANG ; Shijie CHEN ; Guoqing YANG ; Boyu WANG ; Yanxi CHEN ; Guohui LIU ; Dongliang WANG ; Ximing LIU ; Xiaoling TONG ; Guodong LIU ; Hongjian LIU ; Tao LUO ; Zhongmin SHI ; Biaotong HUANG ; Wenming CHEN ; Qining WANG ; Shaojun SONG ; Lili YANG ; Tongsheng LIU ; Dawei HE ; Zhenghong YU ; Jianzheng ZHANG ; Zhiyong HOU ; Zengwu SHAO ; Dianying ZHANG ; Haodong LIN ; Baoqing YU ; Yunfeng CHEN ; Xiaodong ZHU ; Qinglin HANG ; Zhengrong GU ; Xiao CHEN ; Yan HU ; Liming XIONG ; Yunfei ZHANG ; Yong WANG ; Lei ZHANG ; Lei YANG ; Peijian TONG ; Jinpeng JIA ; Peng ZHANG ; Yong ZHANG ; Kuo SUN ; Tao SHEN ; Shiwu DONG ; Jianfei WANG ; Hongliang WANG ; Yong FENG ; Zhimin YING ; Chengdong HU ; Ming LI ; Xiaotao CHEN ; Weiguo YANG ; Xing WU ; Jiaqian ZHOU ; Haidong XU ; Bobin MI ; Yingze ZHANG ; Jiacan SU
Chinese Journal of Trauma 2020;36(5):385-392
TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.