To evaluate the ultrasound imaging characteristics and diagnostic criteria for acute abdominal Meckel's di- verticulum disease (MD), we retrospectively analyzed the ultrasonic characteristics, clinical data of 58 cases of pathologically proved MD from January 2009 to May 2012. We found that among all the 58 patients, 21 patients were diagnosed with the preoperative clinical diagnosis of MD. Fourteen cases of MD inflammation with acute appendicitis were evaluated by pathological examinations after the surgery. We also found 4 cases of MD with perforation, 15 cases of MD with intussusceptions, 14 cases MD with intestinal obstruction, 5 cases of MD secondary to intestinal obstructionor intestinal necrosis, and 5 cases of MD without any obvious complications. Emergency ultrasound examinations revealed 8 cases of simple MD, 1 case of MD with intussusceptions, 9 cases of MD with acute appendicitis, 12 cases of MD with intestinal obstruction, 2 cases of MD with intussusceptions and intestinal obstruction, 1 case of MD with omphalocele and 1 case of MD with abdominal abscess. The emergency sonographic findings suggested that MD was relatively fixed bowel or thick-walled cystic mass, with one end connected to small intestine, and the other end connected to the blind side, at the periumbilicus region or at the lower right abdomen. A conclusion could be drawn that MD is difficult to be detected by ultrasound (detection rate was about 15. 5%), and MD with complications such as intussusceptions, intestinal obstruction, acute appendicitis can usually be more easily detected (detection rates were 24.1%, 24.1% and 15.5%, respectively). Sonography is a simple, effective way to make diagnosis and differential diagnosis of MD with different acute abdomen symptoms from other disease.
Acute Disease ; Appendicitis ; pathology ; Diagnosis, Differential ; Humans ; Inflammation ; Intestine, Small ; pathology ; surgery ; Meckel Diverticulum ; diagnostic imaging ; surgery ; Retrospective Studies ; Ultrasonography

BACKGROUND:Though the high-resolution CT(HRCT)could identify the inner structures of temporal bone.its tiny parts could hardly be observed accurately and clearly by the imaging examinations of auriculotemporal portion,with the influence of scanning layers as well as the partial volume phenomenon.However,it could be easily identified by the combination of thin sections and HRCT images.OBJECTIVE:To introduce a method which could locate the posterior tympanum and its neighboring structures using HRCT images and to provide an anatomical base for the imaging diagnosis and operative treatment on this area.DESIGN,TIME AND SETTING:The observations between the auriculotemporal sections and CT images were finished both in thc Department of Sectional and Imaging Anatomy,Medical College,Nanchang University and the Center of Medical lmageology.Jiangxi Provincial People's Hospital from July 2004 to June 2007.MATERIALS:Fifteen normal adult cadaveric heads(30 sides)which fixed by 100 g/L formaldehyde were scanned,with all the samples provided by the Department of Anatomy,Medical College,Nanchang University.The main equipment was GE Hi-speed Nx/i Sys CT equipment (GE Company,USA).METHODS:Tb obtain CT images of temporal bone(depth 1.00 mm,thickness 1.00 mm),15 normal adult cadaver heads were scanned by CT method taking callthomeatal line(CML)as the baseline.After that,specimens of auriculotemporal portion from temporal bone were taken,decalcified,desiccated and embedded.Sequential sections(thick 1.00 mm)were made.MAIN OUTCOME MEASURES:Comparing sequential sections with CT image,identified respectively the fossa incudis,chorda eminence,styloid eminence,tacial recess,sinus tympanl,ponticulus promontoni,suprameatal spine,etc.RESULTS:The depth of fossa incudas was about(1.49±0.05)mm,the distance from the fossa to pyramid segment of facial nerve was(5.67±0.1 4)mm.The distance from the medial wall of posterior tympanic sinus to the horizontal segment of facial nerve was(3.1 2±0.1 5)mm.The average distance from suprameatal spine to the vertical segment of facial nerve was (16.73±1.24)mm,to chorda tympani nerve(15.87±1.14)mm,to promontory(21.84±2.43)mm.CONCLUSION:Comparing the sectional antomy and CT image of auriculotemporal potion of temporal bone is valuable for the diagnosis and treatment of otopathy.

The aim of the present study was to investigate the diagnostic value of the contrast-enhanced ultrasonography for gastrointestinal stromal tumors (GISTs). The conventional transabdominal ultrasonography and contrast-enhanced ultrasonography using an intraluminal contrast agent were performed in 66 cases. The different diagnostic value between conventional transabdominal ultrasonography and contrast-enhanced hydrocolon ultrasonography was compared, including the depiction ratio and location accuracy. The morpholpgical features of GISTs were observed. The sensitivity of the contrast-enhanced hydrocolon ultrasonography in the depiction of the GISTs (57/66, 86.4%) was higher than that of the conventional transabdominal ultrasonography(33/66, 50%, P<0. 05). Furthermore, the accuracy of the contrast-enhanced ultrasonography in the location of the GISTs (52/57, 91. 2%) was higher than that of the conventional transabdominal ultrasonography (13/33, 39. 4%, P<0. 05). The GISTs with higher or lower risk have different ultrasonic features. The contrast-enhanced ultrasonography was a more valuable diagnostic method for GIST than the conventional transabdominal ultrasonography.
Adult ; Aged ; Contrast Media ; administration & dosage ; Endosonography ; methods ; Female ; Gastrointestinal Neoplasms ; diagnostic imaging ; Gastrointestinal Stromal Tumors ; diagnostic imaging ; Humans ; Male ; Middle Aged

BACKGROUNDTo study the clinical effects of ¹⁵³Sm-EDTMP plus chemotherapy in the treatment of bone metastasis of lung cancer.

METHODSOne hundred and ten lung cancer patients with one metastasis [male 82 and female 28, aged from 32 to 76 yrs; squamous cell carcinoma 28, adenocarcinoma 27, small cell lung cancer (SCLC) 7, mix type 41, alveolar carcinoma 7] who did not undergo an operation were entered into this study. The patients were divided into 3 groups: ¹⁵³Sm-EDTMP therapy only (37 cases), ¹⁵³Sm-EDTMP plus chemotherapy after 3 days (42 cases), 30 days after chemotherapy plus ¹⁵³Sm-EDTMP (31 cases). The dosages of ¹⁵³Sm-EDTMP ranged from 1 111 to 2 660 MBq. The patients with SCLC were adapted CCNU, MTX and CTX; those with non-small cell lung cancer (NSCLC) were adapted MMC, VCR and DDP. Statistic analysis of the data was performed by Chi-square test.

RESULTSTotal pain relief rate for ¹⁵³Sm-EDTMP only was 89.2% , for ¹⁵³Sm-EDTMP plus chemotherapy was 92.8%, and for chemotherapy plus 153 Sm EDTMP was 90.3% . The foci disappeared in 9 cases with ¹⁵³Sm-EDTMP only, in 12 cases with ¹⁵³Sm-EDTMP plus chemotherapy, and in 9 cases with chemotherapy plus ¹⁵³Sm-EDTMP. The 1 year survival rate was 29.7%(11/37) by 153 Sm only, 40.5%(17/42) by 153 Sm plus chemotherapy, 38.7%(12/31) by chemotherapy plus ¹⁵³Sm-EDTMP.

CONCLUSIONS¹⁵³Sm-EDTMP plus chemotherapy is effective in the treatment of bone metastasis of lung cancer.

The critically ill coronavirus disease 2019 (Covid-19) patients usually present acute respiratory distress syndrome (ARDS), or even acute respiratory failure, and require mechanical ventilation (MV) to provide support for breathing. However, clinical studies have found an extraordinarily high mortality rate (>50%) for those Covid-19 patients who underwent MV. Considering the mechanical nature of MV, the high mortality rate is highly possible to be associated with mechanical stretch-induced lung injury during MV. Thus, it is imperative to understand the MV-induced pathological alterations in the respiratory system and corresponding mitigation measures in order to improve the therapy of critically ill Covid-19 patients. Ventilator-induced lung injury in therapy of critically ill Covid-19 patients involves several biomechanical factors and mechanisms, including changes in respiratory parameters, inflammatory cytokines storm, ciliary-mucus system, airway smooth muscle cells, lung fibrosis, and stretch-activated cell signaling. It is hoped that these biomechanical issues can be diligently investigated, so as to provide insights for optimizing the therapy for Covid-19 as well as other respiratory diseases.

Mechanical ventilation(MV)provides life support for critically ill respiratory patients,but in the meantime can cause fatal ventilator-induced lung injury(VILI),and the latter remains a major challenge in respiratory and critical care medicine,because the pathological mechanism has not been fully elucidated.Recent studies show that on the one hand,in the lung with VILI,there exists airway collapse at multi-sites of an individual airway,which can not be explained by traditional airway collapse models.But on the other hand,under MV conditions,airway smooth muscle cells(ASMC)exhibit abnormal mechanical behaviors,accompanied by regulation of Piezo1 expression and endoplasmic reticulum stress.These phenomenons indicate that the MV-induced abnormal mechanical behavior of ASMC is closely related to multiple airway collapse and VILI.Therefore,by studying the MV-induced changes of ASMC mechanical behaviors and their relationship with airway collapse in lung injury,as well as the related mechanochemical signal coupling process,it is expected to reveal a novel mechanism of MV-associated airway collapse and lung injury from the perspective of cell mechanics.In this review,the recent research progress of airway collapse during MV,the regulation of ASMC mechanical behavior by MV-related high stretch,especially the related mechanochemical signal coupling mechanism is summarized.These advances may provide a novel insight for exploring the roles of ASMC abnormal mechanical behavior in the pathological mechanism of VILI,alternative targets of drug intervention for prevention and treatment of VILI,as well as for optimizing the ventilation mode in clinical practice.

This study aimed to evaluate the effect of sanguinarine on biomechanical properties of rat airway smooth muscle cells (rASMCs) including stiffness, traction force and cytoskeletal stress fiber organization. To do so, rASMCs cultured were treated with sanguinarine solution at different concentrations (0.005~5 μmol/L) for 12 h, 24 h, 36 h, and 48 h, respectively. Subsequently, the cells were tested for their viability, stiffness, traction force, migration and microfilament distribution by using methylthiazolyldiphenyl-tetrazolium bromide assay, optical magnetic twisting cytometry, Fourier transform traction microscopy, scratch wound healing method, and immunofluorescence microscopy, respectively. The results showed that at concentration below 0.5 μmol/L sanguinarine had no effect on cell viability, but caused dose and time dependent effect on cell biomechanics. Specifically, rASMCs treated with sanguinarine at 0.05 μmol/L and 0.5 μmol/L for 12 and 24 h exhibited significant reduction in stiffness, traction force and migration speed, together with disorganization of the cytoskeletal stress fibers. Considering the essential role of airway smooth muscle cells (ASMCs) biomechanics in the airway hyperresponsiveness (AHR) of asthma, these findings suggest that sanguinarine may ameliorate AHR via alteration of ASMCs biomechanical properties, thus providing a novel approach for asthma drug development.