Objective:To investigate the application value of multi-slice spiral CT and abdominal ultrasound methods in the clinical diagnosis of acute appendicitis in children.Methods:We included 50 children patients who were pathologically diagnosed with acute appendicitis by the Department of Surgery, Dongyang Maternal and Child Health Hospital from August 2016 to August 2019. Before surgery, all patients underwent multi-slice spiral CT and abdominal ultrasound examinations. We recorded the time taken to complete multi-slice spiral CT and abdominal ultrasound examinations. Taking pathological results as the diagnosis criteria, we also calculated the coincidence rate of each imaging method.Results:The time we took to complete multi-slice spiral CT examination was shorter than that for abdominal ultrasound examination [(13.34 ± 3.86) minutes vs. (23.45 ± 4.77) minutes, t = 11.65, P < 0.05]. The coincidence rate of multi-slice spiral CT in identifying acute simple appendicitis, acute phlegmonous appendicitis, and acute gangrenous appendicitis was 95.24%, 95.00%, and 100.0%, respectively, and it was 71.73%, 70.00%, 88.89%, respectively for abdominal ultrasound examination. The coincidence rates in identifying acute simple appendicitis, acute phlegmonous appendicitis, and acute gangrenous appendicitis were significantly different between multi-slice spiral CT and abdominal ultrasound examinations ( χ2 = 4.29, 4.33, 1.06, all P < 0.05). Conclusion:Compared with abdominal ultrasound, multi-slice spiral CT is easier to operate, takes a shorter time in manipulation, provides more distinct images, and has a higher coincidence rate. Therefore, multi-slice spiral CT is of great diagnostic value for acute appendicitis in children.

BACKGROUND/AIMS: In recent years, endoscopic submucosal tunnel dissection (ESTD) has gained popularity worldwide. The aim of this study was to evaluate the safety and efficacy of ESTD in treating upper gastrointestinal submucosal tumors (SMTs) in a large-volume endoscopic center. METHODS: Patients with SMTs were enrolled in this study between January 2012 and January 2015. Demographic data, clinical data, and treatment outcome were collected and analyzed. RESULTS: Seventy SMTs originating from the muscularis propria (MP) layer were identified in 69 patients. All patients successfully underwent the ESTD procedure. The mean procedure time was 49.0±29.5 minutes, and the mean tumor size was 18.7±7.2 mm. Among all lesions, the majority (70.0%) were located in the esophagus, 12.9% in the cardia, and 17.1% in the stomach. Complete resection was achieved in 67 lesions (95.7%). Perforation occurred in three patients (4.3%), who were treated by endoclips. Pneumothorax occurred in two patients (2.9%) and was successfully managed by thoracic drainage. During a median follow-up of 18.1 months, patients were free of local recurrence or distant metastasis. CONCLUSIONS: Our results demonstrated the feasibility and safety of ESTD in treating upper gastrointestinal SMTs originating from the MP layer. Large-scale comparative studies with other treatment methods should be conducted in the future.
Cardia ; Drainage ; Esophagus ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Pneumothorax ; Recurrence ; Stomach ; Treatment Outcome

Objective To compare the clinical efficacy and safety of Hybrid knife versus triangular tip during peroral endoscopic myotomy(POEM) for patients with achalasia of cardia. Methods Data of patients with achalasia of cardia who received POEM in Nanfang Hospital, Southern Medical University from June 2012 to July 2014 were collected and divided into the Hybrid knife group ( using Hybrid knife) and triangular tip group ( using injection needle and triangular tip). Procedure-related parameters, symptom relief, and adverse events were compared between the two groups. Results A total of 57 patients were selected, including 25 patients in the Hybrid knife group and 32 in the triangular tip group. There were no significant differences on baseline characteristics between the two groups ( P＞0. 05). The mean procedure time was shorter in the Hybrid knife group than that in the triangular tip group (55. 3±17. 7 min VS 69. 5± 9. 4 min, P＝0. 038). The mean frequency of devices exchange was less in the Hybrid knife group than that in the triangular tip group (4. 5±1. 5 VS 10. 7±1. 7, P＝0. 000). No serious complications occurred during operation and periodical follow-up in both groups. At one-year follow-up, the treatment success rate was 92. 0%(23/25) in the Hybrid knife group and 96. 9%(31/32) in the triangular tip group (P＝0. 576). Conclusion Using Hybrid knife in POEM can shorten procedural time and achieve similar treatment success rate compared to triangular tip.