OBJECTIVETo evaluate the value of three-phase pulmonary helical CT in diagnosing peripheral pulmonary cancer (diameter

METHODSSerial single-slice dynamic scans were obtained with helical CT before and after injection of 100 ml contrast material in 60 patients with solitary pulmonary nodules (SPNs, diameter

RESULTSThe delayed times of three-phase pulmonary helical CT were pulmonary artery phase (15 second), bronchial artery phase (36 second), equilibrium phase (90 second) respectively. The prevalence model of density change for three-phase pulmonary helical CT: no enhancement, marked enhancement, moderate-enhancement in pulmonary cancer; slight or moderate-enhancement, marked-enhancement, marked-enhancement in inflammatory nodules; no enhancement or light-enhancement in tuberculoma and metastatic nodules. The enhanced branch and small spot vessels were demonstrated by bronchial artery phase in 82.9% of pulmonary cancer nodules.

CONCLUSIONThe three-phase pulmonary helical CT could reflect the enhancement feature, blood supply of bronchial artery in peripheral pulmonary cancer (diameter
Adult ; Aged ; Aged, 80 and over ; Aorta, Thoracic ; diagnostic imaging ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms ; blood supply ; diagnostic imaging ; Male ; Middle Aged ; Pulmonary Artery ; diagnostic imaging ; Radiographic Image Enhancement ; Solitary Pulmonary Nodule ; blood supply ; diagnostic imaging ; Tomography, Spiral Computed ; methods

OBJECTIVETo observe the feasibility of a segment thoracic esophagus replaced by using a nitinol alloy composite artificial esophagus.

METHODSA nitinol alloy composite artificial esophagus was made of a nitinol tube coated with a silicone membrane with a dacron flange 1 cm proximal to each end. There were ten pigs for the models of experimental animal. The models of experimental animal were established by excised a segment of 7 cm long thoracic esophagus and replaced with the graft. In accordance with the different anastomosis connective way 10 pigs were divided into group I and group II, every group had 5 pigs. In group I monolayer end-to-end anastomosis was used with this prosthesis. In group II monolayer end-to-end anastomosis was used with this prosthesis and above the site of anastomosis adding dacron strip fixed. After operation the operate animals were observed for eating and health. Esophagography and flexible esophagoscopy were performed once a month at the first, second, and third postoperatively month. Three pigs of the grafted prostheses sloughed out spontaneously at different postoperatively period were killed for autopsy and pathologic examination of the neoesophagus.

RESULTSAll pigs had no leakage at the site of anastomosis and survived over 6 months. The longest survival was 20 months. Seven of 10 pigs the grafted prostheses sloughed out spontaneously at 2 to 6 months after the operation (4 in group I and 3 in group II). The grafted prostheses sloughed out spontaneously less than 3 months after operation, marked neoesophageal stenosis in the grafted portion was recognized (3 in group I). They displayed serious difficulty in eating. But the prostheses sloughed out spontaneously more than 3 months after operation, neoesophageal stenosis was increased slightly and the stenosis was only temporary and gradually resolved. (1 in group I, 3 in group II) They lived in good health and without difficulty in eating. Three of 10 pigs the grafted prosthesis still stayed in the grafted place over 10 months (1 in group I, 2 in group II). The neoesophageal had no stenosis. They were perfectly well in eating.

CONCLUSIONSA segment excised pig esophagus replaced with a nitinol alloy composite artificial esophagus is feasible and takes a better result.

Alloys ; Animals ; Artificial Organs ; Biocompatible Materials ; Esophagectomy ; Esophagus ; Female ; Implants, Experimental ; Male ; Prosthesis Design ; Prosthesis Implantation ; Silicone Elastomers ; Swine ; Time Factors ; Titanium

To study the possibility of separation and culture of human umbilical cord blood adherent cell (HUCBAC), the umbilical cord blood CD34(+) cells were cultured in Dexter system in order to evaluate and observe the biological behavior of adherent cells in vitro. The results showed that all cells were cultured with Dexter system. By day 9-14 (at a median of 11.2 days), adherent cell colonies formed and reached their maximum at 15-22 days (mean 19.6 days), by day 28, all adherent cells spread over the bottom of Petri dish. By means of light microscopy, these cells were found to differentiate into three kinds of cells in culture of 28 days: fibroblast-liked cell, macrophage liked cell and small-round cells. The ratio of these three kinds of cells was 56.8%, 38%, 5.5% respectively. Cytochemistry assay revealed that the positive rate reached 100% in NSE stain and PAS stain; the adherent cell by ALP stain were shown 35% positive, but in POX stain the result was negative. Immunohistochemistry stain revealed that the positive rate of cord adherent cells for CD106, CD29, CD44, CD45, CD50, Fn, Ln, collagen IV etc reached 96%, 93%, 98%, 68%, 72%, 92%, 74%, 83% respectively. It is concluded there are hematopoietic adherent precursors in cord blood CD34(+) cells and the HUCBAC shows some biological behavior of hematopoietic stromal cells.
Antigens, CD34 ; blood ; Cell Adhesion ; immunology ; Cell Differentiation ; immunology ; Cells, Cultured ; Fetal Blood ; cytology ; Hematopoietic Stem Cells ; cytology ; immunology ; Humans ; Hyaluronan Receptors ; blood ; Immunohistochemistry ; Integrin beta1 ; blood ; Leukocyte Common Antigens ; blood ; Vascular Cell Adhesion Molecule-1 ; blood

Objective To evaluate the effect of surgical excision of the anterior temporal lobe and hippocampus on the cognitive function of patients with refractory temporal lobe epilepsy. Methods Nineteen patients with refractory temporal epilepsy received surgical excision of the anterior temporal lobe and hippocampus, and cognitive neuropsychologieal assessments were conducted, 3 and 6 months after the surgery, to evaluate the changes in the patinets' cognitive functions. Results Satisfactory effects were achieved in these patients after the operations. One patient showed temporary speech disorder, and two exhibited temporary euphoria. Patients with refractory temporal lobe epilepsy had severe cognitive dysfunctions involving especially in the intelligence, attention and memory, which were not aggravated after the operation, Conversely, the operation resulted in gradual improvement of some of the cognitive functions in these patients. Conclusion Patients with refractory temporal lobe epilepsy have cognitive dysfunction, and surgical excision of the anterior temporal lobe and hippocampus can cure or reduce seizure of temporal lobe epilepsy and improve the cognitive dysfunctions to some extent.

Objective To explore the effect of Internet addiction on adolescent's attention.Methods Neuropsychological evaluations of attention function were done separately in 18 adolescents who met the diagnostic criterion for Internet addiction and in other 18 ones without Intemet addition tendency as a control group. With auditory and visual oddball paradigms, and stimulated by standard,target and novel stimuli, EEG was recorded and analyzed to get the event-related potential P300 and compare the latency and amplitude of P3a and P3b between the 2 groups. Results Compared with the controls, the attention of Internet addiction group was decreased significantly in neuropsychological evaluations. The latency of P3a potentials induced by novel stimulus was much shorter and the amplitude of it was higher in addiction group than in control group, but the latency of P3b potentials generated by target stimulus was prolonged and the amplitude decreased obviously. Conclusions Intemet addiction can cause damage to adolescent's attention function. There is a correlation between the attention impairment and the change of P300 potentials.

Objective:To investigate the effect of psychological support during perithrombotic period on post-stroke depression (PSD) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received intravenous thrombolysis in the Affiliated Lianyungang Hospital of Xuzhou Medical University from January 1, 2021 to July 31, 2021 were enrolled prospectively. The intervention group received one-to-one individual psychological support therapy in the perithrombolytic period on the basis of receiving standard intravenous thrombolytic therapy. At 30 d after onset, Hamilton Depression Scale was used to assess whether PSD occurred. Multivariate logistic regression analysis was used to evaluate the independent influencing factor of PSD. Results:A total of 126 patients with AIS were enrolled, and 86 of them were male (68.25%). Their age was 63.65±10.46 years; 65 were in the intervention group and 61 were in the control group. The incidence of PSD in the intervention group was significantly lower than that in the control group (20.00% vs. 36.07%; χ2=4.049, P=0.044). Multivariate logistic regression analysis showed that psychological intervention (odds ratio [ OR] 0.333, 95% confidence interval [ CI] 0.132-0.838; P=0.020] was an independent protective factor for PSD, while ischemic heart disease ( OR 4.510, 95% CI 1.181-17.217; P=0.028), alcohol consumption ( OR 3.421, 95% CI 1.317-8.888; P=0.012), anticoagulation therapy ( OR 3.145, 95% CI 1.155-8.567; P=0.025) and modified Rankin Scale score before thrombolysis ( OR 1.627, 95% CI 1.142-2.317; P=0.007) were the independent risk factors for PSD. Conclusion:Perithrombolytic psychological support may reduce the incidence of PSD.

OBJECTIVETo investigate the prognostic value of morphology and Hans classification in diffuse large B cell lymphoma（DLBCL）.

METHODSClinical data of 249 patients diagnosed with DLBCL in our hospital and Hangzhou Xixi hospital during Jan 2006 to Dec 2016 were analyzed retrospectively. These patients were classified into 3 groups: immunoblastic variant（IB） group, centroblastic variant（CB） group and others group according to the cell morphology. And DLBCL was also divided into GCB（germinal center B-cell-like）or non-GCB（non-germinal center B-cell-like） group by analyzing the expression of CD10, BCL6 and MUM1 (GCB: CD10 ,BCL6,MUM1/CD10,BCL6,MUM1；non-GCB：CD10,BCL6,MUM1/CD10,BCL6,MUM1).

RESULTSThe univariate analysis displayed that the age，LDH level，IPI，IB，non-GCB，B-symptoms and rituximab all could influence the OS and EFS, the CR rate of CB subtype patients was significantly higher than that of the patients with IB subtype （68.3% vs 38.9%)(P=0.02）. IB subtype was the in dependent prognostic factor for both EFS and OS in the whole study. In multivariate analysis, IPI and IB were the independent prognostic factors for OS and EFS. IB subtype was also an independent prognostic factor in EFS and OS with or without rituximab. The expression of BCL2 and BCL6 was related with prognosis in R-CHOP, but not in CHOP treated patients. Other markers (CD5, CD10, IRF4/MUM1, HLA-DR and Ki-67 proliferation index) were not of the significant prognostic value for DLBCL. When accepted rituximab, the GCB and non-GCB were not different significantly for prognosis. However, the non-GCB group showed a poor prognosis without using rituximab （EFS P=0.020；OS P=0.020）. Multivariate Cox models showed that OS and EFS were not significantly different between GCB and non-GCB group, however, the IB subtype had a very significantly poor prognosis in OS and EFS (P=0.001, P=0.002). When the analysis was restricted to DLBCL with CB morphology only, no prognostic value was observed in Hans classification.

CONCLUSIONThe subtype of immunoblast is a major risk factor in patients treated with CHOP or R-CHOP. There is a significant association between the Hans classification and the morphologic subclassification. Results of this study have supplemented the data for the prognostic factor of DLBCL and demonstrated that the cytomorphologic diagnosis can be reproducible.

Antineoplastic Combined Chemotherapy Protocols ; Cyclophosphamide ; Doxorubicin ; Humans ; Immunohistochemistry ; Lymphoma, Large B-Cell, Diffuse ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Rituximab

OBJECTIVE: To compare the role and importance of fibular fixation in tibiofibular fractures by Meta-analysis. METHODS: The literature related to the comparison of the efficacy of fixation of the fibula with or without fixation on the treatment of tibiofibular fractures was searched through the databases of China Knowledge Network, Wipu, Wanfang, The Cochrane Library, Web of science and Pubmed, and statistical analysis was performed using RevMan 5.3 software. The rates of malrotation, rotational deformity, internal/external deformity, anterior/posterior deformity, non-union, infection, secondary surgery and operative time were compared between the fibula fixation and non-fixation groups. RESULTS: A total of 11 publications were included, six randomised controlled trials and five case-control trials, eight of which were of high quality. A total of 813 cases were included, of which 383 were treated with fibula fixation and 430 with unfixed fibulae.Meta-analysis results showed that fixation of the fibulae in the treatment of tibiofibular fractures reduced the rates of postoperative rotational deformity[RR=0.22, 95%CI(0.10, 0.45), P<0.000 1] and internal/external deformity[RR=0.34, 95%CI(0.14, 0.84), P=0.02] and promoted fracture healing [RR=0.76, 95%CI(0.58, 0.99), P=0.04]. In contrast, the rates of poor reduction [RR=0.48, 95% CI(0.10, 2.33), P=0.36], anterior/posterior deformity[RR=1.50, 95%CI(0.76, 2.96), P=0.24], infection[RR=1.43, 95%CI(0.76, 2.72), P=0.27], secondary surgery[RR=1.32, 95%CI(0.82, 2.11), P=0.25], and operative time[MD=10.21, 95%CI(-17.79, 38.21), P=0.47] were not statistically significant (P>0.05) for comparison. CONCLUSION Simultaneous fixation of the tibia and fibula is clinically more effective in the treatment of tibiofibular fractures.
Humans ; Fibula/surgery* ; Fractures, Bone/complications* ; Tibia/surgery* ; Fracture Healing ; Fracture Fixation, Internal ; Treatment Outcome