Objective ToinvestigatethevalueofDCEGMRIimagingindifferentiatingmalignanttransformationinvertedpapilloma (IP)frombenignIP.Methods 24casesofIPconfirmedbyoperationandpathologywerecollectedfromJanuary2012toJanuary 2018,including14caseswithbenignIPand10patientswithIP malignanttransformation.Thedynamicenhancementparametersof thetwogroups,theproductoftransferconstant(Ktrans),therefluxrateconstant(Kep),theextravascularextracellularspacevolume fraction (Ve)andthedifferenceoftheareaundertheinitialcurve(iAUC)wereanalyzed.Thesensitivityandspecificityofdifferent parametersintheidentificationofbenignIPandIP malignancytransformationwereevaluated.Results Thereweredifferencesno significantdifferenceinageandsexbetweenbenignIPgroupandIPmalignanttransformationgroup.Therewasasignificantdifference abouttheconvolutedcerebriformpatternbetweenthetwogroups(P＝0.004).Therewasnosignificantdifferenceofstagingbetween thetwogroups(P＝0.136).TheKtransvaluesofbenignIPgroupandIPmalignanttransformationgroupwere0.21±0.53 (min－1), 0.36±0.93 (min－1),andtherewasasignificantdifferencebetweenthetwogroups(P＝0.000).TheiAUCvaluesofbenignIPgroupand IP malignanttransformationgroupwere29.05±5.45,41.14±9.47,respectively,andthedifferenceofiAUCbetweentwogroupswas statisticallysignificant(P＝0.001).TherewasnosignificantdifferenceinKepandVebetweenbenignIPfromIPmalignanttransformation (P＞0.05).Conclusion BenignIPhasatypicalconvolutedcerebriG formpatternandtheabsenceofitindicatesmalignanttransformation. Thestagingoflesioncan’tdifferentiatethebenignIPfromIP malignanttransformation.DCEGMRIexaminationisworthyinthe evaluationbenignIPandIP malignanttransformation,especiallyKtransandiAUCvalues.

OBJECTIVETo evaluate the clinical efficacy and safety of three-port transumbilical endoscopic cholecystectomy performed using conventional laparoscopic instruments.

METHODSThirty-two patients undergoing three-port transumbilical endoscopic cholecystectomy using conventional laparoscopic instruments (group A) with 3 ports around the umbilicus were compared with 96 patients (group B) receiving the conventional 4-port routine endoscopic cholecystectomy.

RESULTSAll the procedures were successfully completed without conversion to open laparotomy. In group A, the procedures were completed smoothly in 30 cases while 2 cases required another port (5 mm) punctured below the xyphoid due to severe adhesion around the cyst. The median operating time was 39.7∓5.2 min in group A, significantly longer than that in group B (25.3∓3.3 min, P<0.001), but the patients in group A obtained better cosmetic results (P<0.001); the median blood loss, recovery time of postoperative intestine function, length of postoperative hospital stay, and the rate of use of postoperative painkillers were comparable between the two groups. Bile leakage or other postoperative complications occurred in none of cases in the two groups.

CONCLUSIONIn cases without severe adhesion around the cyst, three-port transumbilical endoscopic cholecystectomy using conventional laparoscopic instruments is a safe and feasible alternative to routine endoscopic cholecystectomy with better cosmetic results.

Adult ; Aged ; Aged, 80 and over ; Cholecystectomy, Laparoscopic ; methods ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Umbilicus ; surgery ; Young Adult

OBJECTIVETo investigate the efficacy and safety of precise laparoscopic Roux-en-Y gastric bypass(LRYGB) in the treatment of obesity and metabolic diseases.

METHODSClinical and follow-up data of obese patients underwent precise LRYGB in our department between June 2011 and April 2013 were analyzed retrospectively.

RESULTSA total of 140 obese patients were included in this study. All the precise LRYGB procedures were successfully performed with no conversion to open surgery or perioperative death. Average operation time was (138.0±21.3) min, postoperative hospital stay was (5.2±1.2) d. No severe complications was observed. The percentages of excess weight loss in 1, 3, 6, and 12 month after operation were (26.4±8.6)%, (53.3±6.7)%, (75.3±7.9)%, (78.5±8.5)%, respectively. The improvement rates of fatty liver, hyperlipidemia, hypertension and type 2 diabetes mellitus were 84.6%(33/39), 92.3%(12/13), 77.3%(17/22) and 82.4%(14/17).

CONCLUSIONSPrecise LRYGB is a modified and optimized traditional surgical technique which does not significantly increase the operative time. It is safe and feasible. The postoperative weight loss effect is significant and it can effectively improve the related co-morbidities.

Diabetes Mellitus, Type 2 ; Gastric Bypass ; Humans ; Hypertension ; Laparoscopy ; Length of Stay ; Metabolic Syndrome ; complications ; Obesity ; etiology ; surgery ; Retrospective Studies ; Weight Loss

The purpose of this study was to investigate the effect of low-magnitude vibration on osteogenesis of osteoblasts in ovariectomized rats with osteoporosis via estrogen receptor α(ERα). The mRNA expression of osteogenic markers were examined with qRT-PCR, based on which the optimal vibration parameter for promoting osteogenesis was determined (45 Hz × 0.9 g, g = 9.8 m/s
Animals ; Cell Differentiation ; Estrogen Receptor alpha/genetics* ; Female ; Osteoblasts ; Osteogenesis ; Osteoporosis ; Ovariectomy ; Rats ; Vibration