Objective To discuss the efficacy and complications of using AngioJet rheolytic thrombectomy in treating acute lower extremity deep vein thrombosis (DVT).Methods The clinical data of 22 patients with acute lower extremity DVT,who were treated with AngioJet rheolytic thrombectomy during the period from February 2015 to August 2016,were retrospectively analyzed.The improvement of clinical symptoms and the thrombus clearance rate were calculated to evaluate the curative effect.The procedure-related complications were documented.Results The clinical symptoms were relieved immediately after operation in all 22 patients.The thigh circumference difference between the affected side and the healthy side decreased from preoperative (4.5±0.6) cm to postoperative (1.0±0.4) cm,the difference in change was statistically significant (P＜0.05).The mean used dose of urokinase was (0.18±0.03) million unit and the average duration of thrombolysis was (4.2±0.7) hours.Complete removal of DVT (＞90％) was achieved in 19 patients,most removal of DVT (50％-90％) in 2 patients,and partial removal of DVT (＜50％) in one patient.After treatment,6 patients developed transient hemoglobinuria,which was relieved after hydration with fluid infusion on the same day.No serious complications such as pulmonary embolism or hemorrhage occurred.Conclusion For the treatment of acute lower extremity DVT,AngioJet rheolytic thrombectomy is safe and effective with less complications.

Objective To evaluate the safety and effectiveness of intraluminal implantation of 125I seeds strand combined with stent placement in treating malignant biliary obstruction. Methods During the period from June 2009 to June 2013, a total of 68 patients with malignant biliary obstruction were admitted to Shanghai Zhongshan Hospital. Interventional management was carried out in all patients. The clinical data were retrospectively analyzed. Of the 68 patients, intraluminal implantation of 125I seeds strand combined with simultaneous stent placement was performed in 41 (combination therapy group) and only stent placement was employed in 27 (conventional therapy group). The survival time, the improvement of obstructive jaundice, recurrence of jaundice and procedure-related adverse events were recorded, and the results were compared between the two groups. Results Implantation of 125I seeds strand and stent placement were successfully accomplished in all patients. Statistically significant differences in serum bilirubin levels, which were separately determined at 7 days and 14 days after the treatment, existed between the two groups (P<0.05). No obvious marrow depression was observed in the combination therapy group. The median survival time of the conventional therapy group and the combination therapy group was 123 days and 215 days respectively. The difference was statistically significant (P < 0.05). Conclusion For the treatment of malignant biliary obstruction, combination use of intraluminal brachytherapy and stent placement is clinically more safe and effective than conventional pure stent placement therapy.

Purpose Papillary thyroid microcarcinoma (PTMC) is difficult to diagnose its nature before surgery, thus results in misdiagnosis. This paper aims to determine the best diagnostic cutoff value using anteroposterior and transverse diameter ratio (A/L) and longitudinal and transverse diameter ration (L/T) in PTMC. Materials and Methods The CT data of 154 pathology proven benign and malignant thyroid nodules ≤ 1.0 cm in diameter in 78 cases were reviewed, including 75 PTMC in 47 patients and 79 benign nodule in 31 patients. The anteroposterior and transverse diameter ratio (A/T) on axial view, A/L on sagittal view, and L/T on coronal view were measured and calculated. A non-parametric method was used to draw the receiver operating curve of A/T, A/L and L/T. The mean and standard deviation of CT diameters in benign and malignant nodules were calculated. The area under the curve, sensitivity, specificity and diagnostic accuracy, positive predictive value and negative predictive value were determined. CT manifestations of small benign and malignant thyroid nodules were also analyzed. Results The A/T and A/L ratio were significantly larger for PTMC than benign nodules (P<0.01), while L/T diameters were significantly smaller than the benign nodules (P<0.01). The area under ROC was 0.8841, 0.7676 and 0.4052 for A/T, A/L and L/T respectively. The best diagnostic cutoff value of A/T and A/L were 1.05 and 1.0. With A/T ≥ 1.05, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 88.00%, 84.81%, 86.36%, 84.62% and 88.12%, respectively. With A/L ≥ 1.0, the sensitivity, specificity, accuracy, positive predictive value and negative predictive values were 66.67%, 82.28%, 74.68%, 78.13% and 72.22%, respectively. CT characteristics of PTMC included superficial location, oval low density, blurry boundary, microcalcification and progressive enhancement with accuracy of 71.43%, 50.00%, 79.22%, 68.83% and 90.91%, respectively. Conclusion The cutoff values of A/T ≥ 1.05 and A/L ≥ 1.0 can be used to diagnose PTMC with high accuracy.

Objective To investigate the expression of granulocyte-macrophage colony-stimulating factor (GM-CSF) and its associated mechanism during the wound healing. Methods The animal model with the full-thickness skin injury was used in the study. Fifty male mice were involved in the study and divided randomly into control group (n = 25) and GM-CSF group (n = 25). Each group had five time points (5 mice per time point). All the mice received full-thickness skin defect (1 cm × 1 cm) through the panniculus camosus on the midline of the back near the neck after anesthesia. Recombinant human granulocyte-macrophage colony stimulating factor (RhGM-CSF) gel (10 μg/cm2) were applied in the GM-CSF group and gel matrix without RhGM-CSF applied in the control group. The wound healing time and rate were observed at days 3, 5, 7, 10 and 14 after injury. The wound specimens were collected to detect the histopathological change. The microvessel density of the wound was counted based on the results of CD31 immunohistochemistry. RT-PCR was employed to detect the expression changes of GMCSF, platelet-derived growth factor (PDGF) , vascular endothelial growth factor ( VEGF) and stromal cell derived factor-1 (SDF-1). Results RT-PCR results showed that the gene expression of GM-CSF reached the peak at day 3 after injury (P＜0. 01) and kept the high level at days 3-10 after injury (P＜ 0. 05) , followed by a sharp decrease to a normal level at day 14 after wound. The wound healing time was average (2.4 ±0. 3) days earlier than the control mice after application of rhGM-CSF, with significant increase of the wound healing rate during 7-14 days after injury ( P ＜ 0. 05 ). In the GM-CSF group, the early histology of trauma wound showed a small number of neutrophils, obvious epithelial cell proliferation in the wound margin, marked hyperplasia of the granulation tissue, high cell density with quantity of spindle-shaped and oval-shaped cells and increased number of new blood vessels. The microvessel density was also increased significantly (P ＜ 0. 05) at days 7-14 after injury. The gene expressions of VEGF and SDF-1 were significantly increased at day 7 and day 10 respectively after injury (P＜0.05) and the gene expression of pro-healing factor PDGF was significantly increased in every time point (at days 5, 7 and 10,P＜0.05;at day 14,P＜0.01). Conclusion GM-CSF expresses highly in the early stage after injury and can promote the wound healing, when the mechanism may relate to the up-regulated expressions of pro-angiogenic factors and pro-healing growth factors.

Objective To evaluate the diagnostic values of MSCT for detecting atherosclerotic plaques on New Zealand rabbits models in comparison with pathologic results. Methods Fifteen New Zealand rabbits were enrolled in this study, including 5 with balloon injury and high-fat diet ( group A), 5 with high-fat diet only (group B) and 5 with regular feed (group C). 16th week late, contrast-enhanced MSCT scan was performed in all rabbits with 16 slice MSCT (16-MSCT) in group A and 64 slice MSCT (64-MSCT) in group B and C. The CT and pathological findings were compared in a double-blind manner. The sensitivities and specificities of 16-MSCT and 64-MSCT for detecting atherosclerotic plaques were evaluated by using Fisher test and x2 test. Results Sixty and seventy-five images on 16-MSCT and 64-MSCT had corresponding pathological slices. The sensitivities for the detection of plaques on 16-MSCT and 64-MSCT were 41.5% (22/53) and 64. 9% (24/37), and spocificities of 85. 7% (6/7) and 89. 5% (34/38), respectively. Conclusions 64-MSCT has a higher sensitivity in the detection of atherosclerotic plaques than 16-MSCT. Both scanners can be used to preclude the diagnosis of atherosclerosis.

OBJECTIVETo study lumbar vertebral degenerations of coal miners with low back pain.

METHODS40 underground miners with low back pain, aged from 30 to 50 years and employed for a length from 10 to 30 years, were taken as observation group. 30 ground workers without low back pain but with almost the same age, employment length and height etc. were selected as control group. Intervertebral discs at L3/L4, L4/L5, L5/S1 were scanned with computerized tomography, comparing herniated discs, sagittal diameter of vertebral canal, height of lateral recess, vertebral hypertostosis, ligament hypertrophy and calcification between two groups.

RESULTSL3/L4, L4/L5, L5/S1 herniated discs and narrow lateral recess in observation group(0.33 +/- 0.15, 0.53 +/- 0.25, 0.45 +/- 0.18 and 0.40 +/- 0.08, 0.31 +/- 0.05, 0.37 +/- 0.07) were more serious than that in control group(0.28 +/- 0.11, 0.32 +/- 0.21, 0.37 +/- 0.19 and 0.42 +/- 0.10, 0.43 +/- 0.07, 0.40 +/- 0.06), but only with significant difference at L4/L5 (P < 0.01). Sagittal diameter of vertebral canal in observation group is narrower than that in control group but of little significance(P > 0.05). Cases of vertebral hyperostosis, ligament hypertrophy and calcification were found more frequent in observation group(45.00%, 42.50%, 22.50%) than in control group(23.33%, 16.67%, 16.67%), but only ligament hypertrophy was remarkable(P < 0.05).

CONCLUSIONSAs compared with control group lumbar vertebral degenerations are more serious in underground miners with manifestations like herniated disc and narrow lateral recess mainly at L4/L5.

Adult ; Coal Mining ; Humans ; Low Back Pain ; diagnostic imaging ; Middle Aged ; Spinal Diseases ; diagnostic imaging ; Spine ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To evaluate the effect of self-expandable occluder on closure of patent ductus arteriosus(PDA)with severe pulmonary arterial hypertension(PH)in adults.Methods Twenty-eight adult patients underwent transcatheter closure of PDA at a mean age of(31.3?11.6)years [(18—58)years].Either Amplatzer duct occluder or domestic device was used in the present study.X-ray,EKG and UCG were repeated in one day,one month,three months,and six months.Results Twenty of the 28 patients had successful occlusion,and the other 8 patients were given up.In the successful group,the narrowest diameter of PDA was(10.4?2.7)mm [(6—16)mm],the diameter of selected occluder was(15.6?3.2)mm [(10—20)mm] at the end of pulmonary artery.Systemic artery oxygen saturation(SAsat)before and after oxygen inhalation was(93.5?1.8)%,(98.2?1.8)%,respectively(P

Objective: To analyze the characteristics and influencing factors of care-seeking delay of adolescent tuberculosis patients in Dongguan City from 2009 to 2018, so as to provide theoretical basis for the tuberculosis control. Methods: The study participants were 8 899 adolescent tuberculosis patients in Dongguan from 2009 to 2018. The Rank-sum test and multiple linear regression were used to analyze the influencing factors of care-seeking days, and the χ 2 test and Logistic regression were used to analyze the influencing factors of care-seeking delay. Results: The median care-seeking days among adolescent tuberculosis patients were 18(6-46) days in Dongguan City from 2009 to 2018, and the prevalence of the care-seeking delay was 56.6%. Multiple linear regression indicated that care-seeking delays were positively associated with being women (B=0.20), living in rural areas (B=0.10), pathogen-positive patients (B=0.69), patients from 2014 to 2018 (B=0.21), and junior school students (B=0.98). Multivariate Logistic regression indicated that care-seeking delay were positively associated with being women (OR=1.35, 95%CI=1.23-1.47), living in rural areas (OR=1.21, 95%CI=1.08-1.37), pathogen-positive patients (OR=2.51, 95%CI=2.26-2.79), patients from 2014 to 2018 (OR=1.24, 95%CI=1.14-1.35), junior-school students (OR=7.58, 95%CI=1.45-39.65), high-school students (OR=5.26, 95%CI=1.04-26.52), university students (OR=7.06, 95%CI=1.39-35.99), and non-students (OR=5.23, 95%CI=1.05-26.08)(P<0.05). Conclusion The prevention and control of tuberculosis among adolescent patients in Dongguan urgently needs to be strengthened. In the future, attention should be paid to the prevalence of care-seeking delay among female, rural, and student tuberculosis patients, and a reasonable prevention and control policy for adolescent patients should be formulated.

Objective To comparatively evaluate the clinical efficacy and adverse events of chemoradiotherapy combined with/without radioactive iodine-125 ( 125-I) implantation for locally advanced non-small cell lung cancer. Methods With locally advanced non-small cell lung cancer admitted to Department of Radiotherapy of Jianhu County People's Hospital and Yancheng Third People's Hospital from March 2014 to March 2015 of 38 patients were enrolled and randomly divided into the observation ( chemoradiotherapy+ radioactive 125-I implantation, n=20) and control groups ( chemoradiotherapy, n=18) . All patients underwent conventional three-dimensional conformal radiotherapy and TC chemotherapy. In the observation group, 125-I implantation was performed at 3 months after chemoradiotherapy. The short-term clinical efficacy, progression-free survival, overall survival and adverse events were statistically compared between two groups. Results The total effective rate in the observation group was 85%, significantly higher than 56% in the control group ( P=0.046) . Until May, 2018, the progression-free survival rates in the observation and control groups were 65% and 61% ( P=0.457) , the overall survival rates were 32% and 26%, and the median survival time was 22.8( 95%CI: 20.5-23.5) and 21.3( 95%CI: 15.9-26.0) months ( P=0.633) . The incidence rates of adverse events in the observation and control groups were 45% and 78% ( P>0.05) . Conclusions Concurrent chemoradiotherapy combined with radioactive 125-I implantation yields high short-term efficacy in the treatment of locally advanced non-small cell lung cancer. It can prolong the long-term survival to certain extent and yield a low incidence rate of severe adverse events, which deserves to be validated by large sample-size investigations.

Objective:To explore the effect of comprehensive intraoperative physical intervention to prevent deep vein thrombosis (DVT) of lower extremity in patients with gynecological tumor surgery.Methods:From January 2020 to January 2021, 80 gynecological tumor patients undergoing surgery in Shanxi Provincial People 's Hospital were selected by convenience sampling as the research object. According to the random number table method, the patients were divided into the control group and the intervention group, each with 40 cases. The intervention group used intermittent pneumatic compression device (IPC) combined with graduated compression stockings (GCS) during the operation. In the control group, IPC was used alone for intervention. This study compared the blood flow rate and tube diameter of the lower extremity veins (common femoral vein, deep femoral vein, popliteal vein, and intermuscular vein) , blood coagulation indexes [prothrombin time (PT) , thrombin time (TT) , activated partial thromboplastin time (APTT) , fibrinogen (FIB) and D-dimer]before and after operation and the incidence of lower extremity DVT on the third day after operation between the two groups. Pearson correlation analysis was used to analyze the correlation between postoperative D-dimer and lower extremity venous blood flow rate. Results:There was no significant difference between the two groups of patients in the preoperative lower extremity venous blood flow velocity and diameter ( P>0.05) . The comparison of postoperative lower extremity venous blood flow rate between the two groups were statistically significant ( t=2.217, 4.863, 2.946, 2.397; P<0.05) . The diameters of common femoral vein, deep femoral vein and intermuscular vein between the two groups were statistically different ( t=2.117, 2.756, 2.274; P<0.05) , and there was no significant difference in the diameter of popliteal vein ( P>0.05) . There was no significant difference in PT, TT, APTT, FIB, D-dimer between the two groups of patients before operation ( P>0.05) . The differences in FIB and D-dimer between the two groups of patients were statistically significant ( t=-2.338, -3.554; P<0.05) . The incidence of lower extremity DVT in the intervention group was 2.5% (1/40) on the third day after operation, and the incidence of lower extremity DVT in the control group was 20.0% (8/40) , and the difference was statistically significant (χ 2=6.135, P<0.05) . Pearson correlation analysis showed that postoperative D-dimer and lower extremity venous blood flow rate were negatively correlated ( r=-0.484, -0.442, -0.358, -0.308; P<0.01) . Conclusions:The application of comprehensive intraoperative physical intervention of IPC combined with GCS can reduce the incidence of DVT in the lower extremities of patients with gynecological tumors, and it is worthy of clinical application.