Objective To prospectively evaluate the efficacy and safety of Computed Tomography (CT)-guided microcoil localization for pulmonary small solid nodules and ground-glass opacity prior to thoracoscopic resection.And to investigate the indication for CT-guided microcoil localization for small solid pulmonary nodules and ground-glass opacity.Methods From December 2012 to February 2014,85 enrolled patients with pulmonary solid nodules and ground-glass opacity underwent CT guided microcoil localization prior to video assisted thoracoscopic surgery.The procedures of localization were performed by trailing method or routine method under CT guided percutaneous pneumocentesis.For Trailing method,the microcoil was placed with the distal part coiled adjacent to the lesion and the proximal end coiled beyond the parietal pleura.By routine method,the entire microcoil was injected adjacent to the lesion.Results CT-guided microcoil placements were successful in all ninety-one lesions,including 15 solid nodules,15 mixed ground glass opacity,and 61 pure ground glass opacity,with an average diameter of 8.75mm(5-26 mm).The Complication rate of the localization procedure was 23.5％ (20/91),with 13 cases of asymptomatic pneumothorax,and 7 cases of pulmonary hematoma.None patient required surgical intervention,nor severe Complication occurred.All patients underwent video assisted thorascopic surgery on the same day or the next few days after microcoil localization.VATS removal of the pulmonary lesions was successful in all patients.However,two of 91 microcoils were found displaced during VATS resection.The success rate of microcoil marking VATS resection for pulmonary small solid nodules and ground-glass opacity was 97.8％.Microcoil marking was required for 84.6 percent of all the resected lesions.Conclusion Preoperatively CT-guided microcoil localization for pulmonary small solid nodules and ground-glass opacity is a feasible safe and effective marking technique for video assisted thoracoscopic resection.The indication for microcoil localization in our study meet the requirement of VATS resection.

Objective The aim of this study is to evaluate the efficacy and safety of preoperative Computed Tomography (CT)-guided microcoil localization for pulmonary ground-glass opacity.Methods We performed CT-guided Microcoil localization in 30 patients with 32 pure ground glass opacities between December 2012 and September 2013.All 30 patients underwent CT-guided micmcoil localization under local anesthesia with a 21G needle percutaneous lung biopsy.All patients accepted video-assisted thoracic surgery after the localization the same day or the next day.Results We located 32 pure ground glass opacitiesin 30 patients.The mean lesion diameter was 0.94 cm,the average depth from the visceral pleura was 0.71 cm,all leisons were successfully located by microcoil,asymptomatic pneumothorax was observed in seven patients,pulmonary hematoma was observed in two patients,pain was observed in one patient,dislodgement was found in one patient during the operation.None of these cases needed surgical treatment.Pathologic diagnoses of the target leisions were as follows:adenocarcinoma in situ (n =17),adenocarcinoma(n =9),atypical hyperplasia(n =4),inflammation (n =2).After the placement of preoperative CT-guided microcoil localization for pulmonary ground-glass opacity,all the 32 pulmonary pure ground-glass opacities resection success rate was 100％.Conclusion Preoperative CT-guided microcoil localization for pulmonary pure ground-glass opacity is a safe and effective way to improve the accuracy of surgical resection.

Adult ; Aorta ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Marfan Syndrome ; surgery

Objective To evaluate diagnosis and preoperative management of cases with interrupted aortic arch(IAA)in infancy.Methods Fifty-three infants who were admitted to our hospital from Jan.2001 to Nov.2007 were involved.Clinical data,findings of echocardiogram(Echo),spiral CT,MRI,angiocardiography,preoperative management,surgical repair and postoperative outcome were analyzed retrospectively.Results There were 38 boys and 15 girls,weighted 2.18-10.0(4.32?1.60)kg,aged 1 day to 12(3.05?3.53)months,of which 50.94% were neonates.Symptoms at presentation were 90.57% with tachypnea and 83.02% with difficulty in feeding.Eighty three point zero two percentage cases had different degree of congestive heart failure,37.74% of which were in grade Ⅲ heart function.All cases had weakened femoral pulse.All cases were performed Echo,38 cases of them diagnosed as IAA,6 cases as IAA or severe coarctation of aorta(CoA);they were diagnosed as IAA by CT,and 9 as severe CoA who were diagnosed as IAA via CT or operation.Thirty-three cases were performed CT,of which 15 underwent surgical repair,cardiovascular abnormalities revealed by CT were the same as those in surgical findings.Three cases were taken MRI,and 7 cases were performed angiocardiography.According to the results of Echo,CT,MRI,angiocardiography and surgical findings,35 cases were type A,15 cases were type B and 3 cases were type C.Preoperative treatment included maintaining patent ductus areriosis,management of heart failure and supportive treatment.After proper preoperative management of medication,most cases with congestive heart failure were improved.Twenty-six cases underwent surgical repair,16 survived,10 died du-ring perioperative stage.Main cause of death was severe low cardiac output.Conclusions Value of Echo in diagnosis of IAA is limi-ted.Combination of Echo with CT or MRI is a convenient and safe way to diagnose IAA,it can replace the traditional method of Echo combined with angiocardiography.Proper preoperative management is helpful to patients with IAA to pass to surgical repair,and makes for successful operation.

Objective:To explore the clinical application of distal and proximal bilateral lateral pre-decompression in replant of digit degloving injury.Methods:From March 2012 to May 2021, 14 patients with 29 digits had replantation surgery of degloved soft tissue and severed digits in Section II, Department of Orthopaedics, Changzhou Medical District of 904th Hospital of PLA Joint Logistic Support Force. There were 2 types of injuries: degloving injury of soft tissue but with intact digital tip, and digital tip degloving injury with intact distal phalanx and nail bed. With the technique of distal and proximal bilateral lateral pre-decompression, pre-decompression incisions were made to the subdermal on both sides of the degloved skin over the proper palmar digital arteries. From where, the distal stump of the proper palmar digital arteries and nerves for anastomosis were found and had them anastomosed with the proximal proper palmar digital arteries and proper palmar digital nerves, then anastomosed digital pulp and digital dorsal veins (11 cases were direct anastomosis and 3 cases were bridged anastomosis). Follow-up was carried out by outpatient consultation, telephone and WeChat APP. The appearance of the digit body, the shape of digital pulp, the nails grow and the motions of the digits were observed, and the Evaluation Standard of Replantation of Severed Fingers by the Society of Hand surgery of Chinese Medical Association was used to evaluate the recovery of function.Results:All 29 segments of degloving digit survived. Small necrotic areas was found in 4 digits and healed after the change of dressing. The followed-up time was lasted for 3-36 months. There was no obvious atrophy found in all the digits. Appearances of digit pulp and nails were satisfactory with good sensational recovery for TPD at 6-10 mm, 7 mm in average. Motions of all the repaired digits were good. According to the Evaluation Standard of Replantation of Severed Fingers by the Society of Hand surgery of Chinese Medical Association, 23 digits were in excellent, 4 in good and 2 in poor, with a satisfactory rate at 93.1%.Conclusion:For a distal digit injury with intact distal soft tissue and relatively mild injury of blood vessels and nerves, using the method of distal and proximal bilateral lateral pre-decompression can help to achieve good appearance in survived digital pulp, good sensational recovery and good nail growth. An individualised treatment intra-and-after the surgery could offer an ideal therapeutic effect.

Objective To investigate the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in Chinese patients with ischemic stroke . Methods In this multi‐center study ,2 310 continuously inpatients with ischemic stroke diagnosed in 20 stroke screening and prevention project base hospitals from June 2015 to M ay 2016 were enrolled . Carotid ultrasonography and transcranial color‐coded sonography or transcranial Doppler were performed in all patients to confirm the presence of cerebral artery stenosis or occlusion . According to the distribution of lesions ,the subjects were divided into 2 groups :the simple intracranial artery stenosis group and the simple extracranial artery stenosis group . T he difference of risk factors between the two groups was compared . Results Of the 2 310 patients with ischemic stroke ,1 516 ( 65 .6% ) had simple intracranial artery stenosis and 794 ( 34 .4% ) had simple extracranial artery stenosis . T he incidence of anterior circulation artery stenosis was higher in the group of intracranial artery stenosis than that in the extracranial artery stenosis group ( 68 .1% vs 48 .7% , P ＜0 .001) . Posterior circulation artery stenosis and combined anterior with posterior circulation artery stenosis were more common in patients with extracranial artery stenosis group than those in intracranial artery stenosis group ( 36 .4% vs 22 .1% ,14 .9% vs 9 .8% ;all P ＜0 .001) . Univariate analysis of risk factors for stroke showed that patients with intracranial arterial stenosis had a higher prevelence of hypertension , diabetes ,obesity ,and family history of stroke ,and their systolic blood pressure ,diastolic blood pressure , body mass index ( BM I) ,fasting blood‐glucose ,glycosylated hemoglobin ,triacylglycerol ,total cholesterol , and low‐density lipoprotein cholesterol were significantly higher than those in the extracranial arterial stenosis group ( all P ＜ 0 .05 ) . T he proportion of elderly ( ≥ 65 years old ) ,male and smokers in the extracranial arterial stenosis group was significantly higher than that in the intracranial arterial stenosis group ( all P ＜0 .05) . Multivariate logistic regression analysis showed that elderly ( ≥65 years old) ,male , and smoking history were independent risk factors for extracranial arterial stenosis ( OR＝ 2 .012 ,1 .637 , 1 .325 ,respectively ;all P ＜0 .05) . While hypertension ,diabetes ,less physical activity ,and high BM I levels were independent risk factors for simple intracranial arterial disease ( OR ＝ 1 .301 ,1 .252 ,1 .248 ,1 .030 , respectively ;all P ＜0 .05) . Conclusions There are significant differences in the distribution characteristics and risk factors of intracranial and extracranial aterial lesions in patients with ischemic stroke in China .

OBJECTIVETo study the history, clinical symptoms, imaging and histology of a rare distinct infantile hemangioma.

METHODS12 patients (5 female, 7 male; aged 18 months - 26 years) diagnosed as non-involuting congenital hemangioma were retrospectively analyzed. The history, imaging, histologic examination and the treatment were collected.

RESULTSMost of the patients had only one lesion which was round or ovoid, flat or plaque-like. The average size was about 5 cm x 6 cm. The overlying skin was usually had coarse telangiectasia with central or peripheral pallor. The skin has a high skin temperature. Magnetic resonance imaging, computed tomography angiography and digital subtraction angiography findings were similar to those of common infantile hemangioma. Histologic examination revealed lobular collections of small, thin-walled vessels with a large, often stellate, central vessel. "Hobnailed" endothelial cells lined along the intralobular vessels. Small arteries were observed "shunting" directly into lobular vessels or into abnormal extralobular veins. All lesions were easily excised without recurrence.

CONCLUSIONSNon-involuting congenital hemangioma is a distinct infantile vascular tumor. It should be diagnose early and treated appropriately.

Adolescent ; Adult ; Angiography ; methods ; Angiography, Digital Subtraction ; Child ; Child, Preschool ; Female ; Hemangioma ; congenital ; diagnosis ; therapy ; Humans ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Young Adult

OBJECTIVETo study the changes of dietary pattern among adult residents in different areas of Liaoning province from 1989 to 2006.

METHODSHealthy adults (6213 subjects) at age of 18 - 65 years from 480 households in three cities (Shenyang, Yingkou, Wafangdian) and three counties (Qingyuan, Huanren, Chaoyang) were selected with stratified multiple cluster random sampling. The information on nutrient intake of the subjects were collected from datasets of Chinese Health and Nutrition Survey conducted in 1989, 1991, 1993, 2000, 2004, and 2006. Different food intake, the nutrients intake percentages for recommended nutrition intake (RNI) and appropriate intake (AI), and the percentages of total energy and protein from grain, animal product, bean and its product were calculated to assess the residents' dietary pattern and nutrition status. The changes of dietary pattern among adult residents were analyzed.

RESULTSAmong the residents, there were a 38.1% of decreased intake for grain (from 601.9 to 372.5 g/d), 20.5% for potato (from 75.6 to 60.1 g/d), 25.1% for beans (from 38.7 to 29.0 g/d), and a 77.2% of increased intake for fish and shrimp (from 25.0 to 44.3 g/d), 36.9% for livestock and poultry (from 65.6 to 89.8 g/d), 47.7% for fruit (from 70.7 to 104.4 g/d), and intake of milk product (from 5.8 to 21.3 g/d), egg (from 17.3 to 35.7 g/d), vegetable (from 296.1 to 316.3 g/d) were also increased from 1989 to 2006. During the period, the intake percentages of energy and protein from grain decreased from 67.5% (8.7 MJ/12.8 MJ per day) to 51.5% (5.0 MJ/9.6 MJ per day) and from 72.0% (66.2 g/91.9 g per day) to 59.7% (45.3 g/75.9 g per day), and on the contrary those from animal products increased from 8.9% (1.1 MJ/12.8 MJ per day) to 14.8 (1.4 MJ/9.6 MJ per day) and from 15.9% (14.6 g/91.9 g per day) to 27.9% (21.2 g/75.9 g per day), respectively. In 2006, the intake of vitamin A (508.9 µg/d) was 67.6% of it's RNI, intake of vitamin B(2) (0.9 mg/d) was 64.6% and the intake of calcium (453.7 mg/d) was 52.5% of it's AI among the residents.

CONCLUSIONThe intake of plant food decreased and that of animal food increased from 1989 to 2006 and the dietary intakes of calcium, vitamin A, vitamin B(2) need to be increased among adult population of Liaoning province.

Adolescent ; Adult ; Aged ; China ; Diet Surveys ; Feeding Behavior ; Female ; Humans ; Male ; Middle Aged ; Nutritional Status ; Young Adult

Purpose To detect the expression of autophagy-related genes Beclin1 and microtubule-associated protein1 light chain3 (LC3) in ovarian serous carcinoma (OSC) and to analyze the correlations with clinical pathological characteristics and prognosis of patients with OSC.Methods Immunohistochemical staining of MaxVision two-step was performed to detect the expression of Beclin1 and LC3 in the samples from 63 OSC patients and 20 with benign ovarian serous cystadenomas.The relation between Beclin1 and LC3 with the factors influencing the prognosis of OSC was investgated.The expression levels of mRNA and proteins in 10 fresh OSC samples and their corresponding adjacent noncancerous tissues were examined by RT-PCR and Western blot.Results The positive percentage of Beclin1 and LC3 protein in the tissues of OSC was 36.51％ and 33.33％,which was significantly lower than that of 65.00％ and 60.00％ in serous cystadenomas (P =0.025,P =0.034).The expression of Beclin1 in OSC was significantly correlated with clinical FIGO stage and pathological grade (P =0.001,P =0.001),but not associated with age,site,tumor size and lymph node metastasis (P ＞ 0.05).The expression of LC3 protein in OSC was significantly with clinical FIGO stage and lymph node metastasis (P =0.013,P =0.041),but not associated with age,site,tumor size and pathological grade (P ＞ 0.05).There was a positive correlation between Beclin1 and LC3 in OSC (rs =0.373,P =0.03).The levels of Beclin1 and LC3 mRNA (0.581-±0.091,0.650 ±0.090) in 10 fresh OSC were significantly lower than in their adjacent noncancerous tissues (t=8.083,t =6.614,P =0.016,P =0.022).The levels of Beclin1 and LC3 protein in 10 fresh OSCs were significantly lower than in their adjacent noncancerous tissues (P ＜ 0.05).Kaplan-Meier survival analyses revealed that the expression of Beclin1 and LC3 were associated with the patients prognosis (P =0.028 3,P =0.018 5).Conclusion Expression of Beclin1 and LC3 protein is down-regulated in the tissues of OSC which lead to decrease of function of autophagy.The decrease of Beclin1 and LC3 may be associated with the development and prognosis of OSC.

Objective To analyze the correlation between smoking and occurrence of intracranial artery stenosis.Methods From June 2015 to May 2016,a total of 10 711 inpatients with transient ischemic attack (TIA) or ischemic stroke from 20 basel hospitals of nationwide were enrolled using a cross-sectional study,76 patients with unknown smoking and smoking cessation years were excluded.Finally,a total of 10 635 patients were enrolled.Transcranial color coded sonography and/or transcranial Doppler were used evaluate the intracranial artery stenosis lesions.The basic risk factors for cerebrovascular disease (age,sex,smoking and smoking years,whether smoking cessation and years,hypertension,diabetes,hyperlipidemia,atrial fibrillation,and family history of stroke) were recorded.According to the different smoking years,the smoking years were divided into five groups:non-smoking,smoking time ≤10-year,11 to 20-year,21 to 30-year,and >30-year groups for trend chi square test.According to the different smoking cessation years in the smokers,the smoking cessation years were divided into four groups:non-cessation,cessation time 1 to 10-year,11 to 20-year,and >20-year groups for trend chi square test.The effects of different smoking years and different smoking cessation years on the occurrence of intracranial arterial stenosis were analyzed.Results The incidence of intracranial artery stenosis in the smokers (40.4%[1 433/3 547]) was significantly higher than that in the non-smoking patients (29.4%[2 085/7 088]).There was significant difference (χ2=128.850,P<0.01),and the incidence of cerebral infarction in the smokers (91.6%[3 250/3 547]) was significantly higher than the non-smokers (85.0%[6 027/7 088]).There was significant difference (χ2=92.328,P<0.01).Smoking was an independent risk factor for intracranial artery stenosis (OR,1.603;95%CI 1.456-1.765;P<0.01).With the increase of smoking years,the detection rate of intracranial arterial stenosis increased gradually (trend χ2=115.437,P<0.01).Whether giving up smoking had no significant effect on the incidence of intracranial artery stenosis in patients with ≥20 years of smoking (trend χ2=1.043,P=0.307).Conclusions Smoking is an independent risk factor for affecting intracranial artery stenosis;the risk of disease increases with the number of smoking years.Long-term smokers (≥20 years) cannot reduce the effect on intracranial artery stenosis,even if they give up smoking.