Objective To evaluate clinical value of ultrasonography before and after stent implantation in the patients with obstructive jaundice.Methods Ultrasonic findings before and after stent implantation in 38 patients with obstructive jaundice were analyzed respectively,and location and pathological natures of the obstruction were compared with those of stent implantation.Results Stent implantation was successfully achieved in all the cases with hilum (15/15,100%) and common bile ducts obstruction(12/12,100%),ampulla of Vater (5/6,83%) ,and duodenal nipple(1/5,20%).A success rate of stent implantation was 100%(8/8) in benign lesions,and 83.3% (25/30) in malignant ones.The total success rate was 86.8%.The significant difference was found between the obstruction location and success rate of stent implantation ( P 0.05 ).Conclusions Ultrasonography not only contributes to diagnosis of location and pathological nature of the obstruction for successful stent implantation but also explores complications early.

The study was made on 3H-leucine incorporation into brain of offsprings born by their mothers who were fed in severe iodine deficiency area. Control group received an iodine-supplemented diet (1.7mg KIO3/kg food). Disintegration per minute (dpm) was used as an index to assess the 3H-leu-cine incorporation rate in comparision of the two groups.The results of 3H-leucine incorporation into brain showed that the dpm/mg of brain cortex and cerebellum was significantly lower in experimental group than that of control group at the time of 1-14 hours after injection of the preparation on 11-day offsprings (p

Objective: To study the Ross procedure in surgery for aortic valve disease. Methods: From October, 1994 to May, 2002, 7 patients underwent Ross operation for aortic valve diseases. Pulmonary homografts were used for reconstruction of right ventricular outflow tract (RVOT). Among them, male 4, female 3, age from 11 to 44 years old [average (28?10) years]. All had severe aortic valve regurgitation, 2 associated with moderate aortic valve stenosis, 1 with bicuspid aortic valve, 1 with atrium septal defect, and 1 with ventricular septal defect. Pulmonary valve function was normal in all patients. Results: There was no operative death. One patient died 3 years later of SBE. Echocardiography indicated the normal function of aortic and pulmonary valve and excellent heart function. Conclusion: Ross operation provides is difficult but yields excellent clinical results.

Objective: To evaluate the long-term result after bioprosthesis replacement, and analyse the risk factors of the late deaths. Methods: From September 1984 to March 1988, 90 patients underwent bioprosthesis replacement in our hospital. There were 39 males (43%) and 51 females (57%) with an average age of 36.1 years. 78 patients had rheumatic disease, 8 degenerative disease, 3 congenital mitral valve anomaly and 1 Ebstein's anomaly. The preoperatively heart function (NYHA) was grade II in 15, grade III in 54, and grade IV in 21. C/T was 0.51～0.90 (average 0.65?0.10). Results: The operative mortality rate was 7。8%. All survived patients were followed up. The mean follow-up time was 7.8 years (range from 3 months to 15.7 years. 35 patients died during the follow-up period. The causes of death cardiac related deaths in 33 patients (88.6%), noncardiac related death in 3 (8.6%), and unknown in 1 (2.8%). Reoperation was performed in 20patients. At 1, 5 and 10 years after operation, the actuarial survival rate of patients were 92.7%, 80.7% and 57.8%, respectively. Multiple regression analysis showed that preoperatively cardiac function, C/T ratio and EF were risk factors for late deaths. Conclusion: The long-term results with bioprosthesis replacement appear satisfactory.

Objective To investigate the prevalence of morphological abnormalities of the internal carotid artery and relationship with ischemic cerebrovascular disease and carotid atherosclerosis.Methods A total of 511 consecutive patients were enrolled in this study and carotid abnormalities were classified according to the criteria of Wain and Metz by combining high-and low-frequency ultraaonography prospectively.Relationship of carotid abnormalities to ischemic cerebrovascular disease and carotid atherosclerosis were analyzed.Results Of the 511 cases,abnormalities of the internal carotid artery were found in 256(50.1 ％),the unilateral carotid abnormalities were found in 121(23.7％),and the bilateral in 135(26.4％),respectively.There was significantly difference in prevalence of kinking and coiling between ischemic stroke and asymptomatic group(P＜0.001),and prevalence of carotid abnormalities in the plaques and arteriosclerosis groups were statistically higher than the normal group(P＜0.001).Conclusions The kinking and coiling of the internal carotid artery could be additive risk factors in the pathophysiology of an ischemic stroke,and carotid morphological abnormalities could be responsible for carotid atherosclerosis partly.

Objective To investigate color Doppler flow imaging features of the ophthalmic artery,external carotid artery,which is known the secondary compensatory collateral circle,in patients with unilateral internal carotid artery occlusion.Methods A total of 42 patients with unilateral internal carotid artery occlusion were enrolled,and ipsilateral and contralateral ophthalmic artery,external carotid artery were examined by color Doppler flow imaging,prospectively,peak systolic velocity,pulsatility index and resistance index were analyzed and compared with findings of control group.Results In the 42 cases with internal carotid artery occlusion,the compensatory collateral circle was observed by the external carotid artery and ophthalmic branches,through their communicating arteries in 40 (95.2％) cases of chronic occlusion.Compared with the contralateral side,the ophthalmic arteries were characterized by retrograde blood flow,peak backward shifting,increase of diameter [(1.91 ± 0.53) mm vs (1.69 ± 0.34) mm,P =0.009] and peak systolic velocity [(43.41 ± 27.28) cm/s vs (29.91 ± 14.16) cm/s,P =0.003],reduced pulsatility index (1.18 ± 0.49 vs 1.69 ± 0.73,P =0.000) and resistance index (0.65 ± 0.26 vs 0.75 ±0.12,P =0.000),and prolonged acceleration time [(147.71 ± 56.16)ms vs (51.80 ± 7.81)ms,P =0.000].Ophthalmic arteries had antegrade blood flow with a decrease of peak systolic velocity and resistance in another two cases of acute thrombosis of ICA.Conclusions External-ophthalmic-internal carotid artery passway is another compensatory collateral circle for the chronic occlusion,but only by ipsilateral and contralateral internal carotid artery circle,for acute thrombosis.

Objective To summarize the clinical experience for treating anterior mitral leaflet prolapse with an artificial chordal loop. Methods From January 2008 to August 2009, pre-measured ePTFE loops were used to treat anterior leaflet prolapse in 8 patients, 5 males and 3 females, aged from 28 to 68 ( average 56.0 ± 8.9 ) years. The heart function (NYHA) was class Ⅱ in 2 patients and class Ⅲ in 6. Echocardiography showed chordal rupture in 7 patients, 2 with chordal rupture and elongation and pure chordal elongation in 1. There were 3 patients with A1 segment prolapse of anterior mitral leaflet, 2 with A2 segment prolapse, 3 with both A2 and A3 segments prolepses by Carpentier standardization. There were 2 patients with posterior leaflet chordal rupture in P2 and P3 segment, 1 with cor triatrium. Left ventricular end diastolic diameter (LVEDD) was 53 - 62 mm [average ( 57.2±3.8 ) mm]. Ejection fraction (EF) was 0.60 - 0. 68 ( average 0.63 ± 0.02). Heart-thoracic ratio was 0. 52 ± 0. 17. We measured the normal chordal using both a caliber and by echocardiography ( for comparison after operation). The artificial chordal loops was constructed on the caliber using ePTFE suture, and then fixed the loop to the papillary muscle and the free edge of the anterior leaflet. Results There was no operation death. Hemolysis after 2 days of operation in 1 patient was amended by alkalinization, diuresis and hormone treatment. Pre-discharge transthoracic echocardiography showed mild regurgitation in 1patient, trivial regurgitation in 7. LVEDD were 42 -51mm [average (47. 1 ±2.2) mm] significantly decreased than that of pre-operation. Following parameters were measured and compared with pre-operation: EF 0. 58 ± 0. 03 vs. 0. 63 ± 0. 02, beart function ( NYHA ) class 1.25 ± 0. 42 vs. 2.75 ± 0. 58. Normal chordal length measured by caliber was ( 21.20 ± 1.55 ) mm vs. ( 22. 10 ± 2.68 ) mm by echocardiography. Anticoagulate therapy with warfarin was for 3 months after discharge and followed-up all the patients [1 - 19 months, average (8.2 ± 4.3 ) months]. Post operative echocardiography showed mild regurgitation in 1 patient, no or trivial regurgitation in 7 patients. The heart function class was evident improved compared with pre-operation :6 patients in class Ⅰ , 2 patients in class Ⅱ. Conclusion The pre-measured ePTFE loop is reliable and reproducible confirmed by short term follow-up for treating anterior leaflet prolapse.

0.05).Conclusion The segmental bronchus were visualized reliably by low-dose multi- detector-row CT with 17 mAs. Low-dose CT can be adapted to CT screening for early lung cancer.

This study aims to explore the inferior adhesion of the renal fascia (RF), and the inferior connectivity of the perirenal spaces (PS) with multidetector computed tomography (MDCT), and to investigate the diagnostic value of CT for showing this anatomy. From May to July 2012, eighty-two patients with acute pancreatitis presented in our hospital were enrolled into this study and underwent contrast-enhanced CT scans. All the image data were used to perform three dimensional reconstruction to show the inferior attachment of RF and the inferior connectivity of PS. The fusion of anterior renal fascia (ARF) and posterior renal fascia (PRF) next to the plane of iliac fossa were found on the left in 71.95% (59/82) cases, and on the right in 75.61% (62/82). In these cases, bilateral perirenal spaces, and anterior and posterior pararenal spaces were not found to be connected with each other. No fusion of ARF and PRF below the level of bilateral kidneys occurred on the left side in 28.05% (23/82) cases and on the right side in 24.39% (20/82). In these patients, the PS extended to the extraperitoneal space of the pelvic cavity and further to the inguinal region, and bilateral anterior and posterior pararenal spaces were not found to be connected with each other. Three-dimensional reconstruction on contrast-enhanced MDCT could be a valuable procedure for depicting inferior attachment of RF, and the inferior connectivity of PS.
Abdominal Cavity ; anatomy & histology ; Adult ; Contrast Media ; Fascia ; anatomy & histology ; Humans ; Image Processing, Computer-Assisted ; Kidney ; anatomy & histology ; Multidetector Computed Tomography ; Pancreatitis ; pathology ; Pelvis ; anatomy & histology ; Tomography, X-Ray Computed

Objective To investigate the effect of cobalt chloride on tumor cell proliferation and apoptosis in vitro, to explore the reasonable strategy of chemical hypoxia induced by CoCl2. Methods Two tumor cell lines (A549 and HeLa) were respectively exposed to CoCl2(0.05～2 mmol/L) for different time period (4～48 h), cells viability、proliferation and apoptosis were maesured by MTT and FCM methods. HIF-1? and related apoptosis proteins expression were detected by Western blot. Results Cells viability was weakly changed in low concentration(≤200 ?mol/L)of CoCl2 within 24 h. However, higher dose or prolonged challenge of CoCl2 significantly decreased cell survival rate (P