Objective To evaluate the diagnostic value of computer-aided diagnosis with three-dimensional volumetric measurement in solid pulmonary nodules on follow-up CT. Methods Forty-six patients with 58 solid nodules were evaluated.Each patient underwent chest CT at least twice.The volume, doubling times(DTs) and volumetric growth rates(VGRs) of nodules were calculated with three-dimensional volumetric measurement software. If there were significant statistical differences in DTs between malignant and benign nodules, Nonparametric test was used to make the analysis.If there were significant statistical differences in upper DTs'values between malignant and benign nodules, X2 test was used to make the analysis.Final diagnosis of all nodule were confirmed by pathology or by response to diagnostic therapy or by clinical follow-up.Results The DTs of 13 malignant nodules were <400 days in 12 nodules, with a range from 45 to 465 days (median, 159 days) ; the VGRs ranged from 8% to 329% (median, 30.0%).The VGRs of 45 benign nodules ranged from -38% to 24% (median, 0%).The DTs of 24 benign nodules that increased or not changed in size were >400 days in 22 nodules, with a range from 302 days to 55 158 days (median, 2 704 days); the VGRs ranged from 0 to 24% (median, 6.5%. Twenty-one nodules that decreased in size had the VGRs ranging from -38% to -4% (median, - 16.0%), and the DTs of these nodules could not be calculated by software.There were significant statistical differences in DTs between malignant and benign nodules(P <0.05).Taking 500 days, 400 days and 300 days as the upper value for malignancies there were statistically significant differences in these values between malignant and benign nodules(P < 0.01).Their sensitivities were 100.0%, 92.3%, 76.9% respectively and specificities were 87.5%, 91.7%, 100.0% respectively.Accuracies were 91.9%, 94.6% ,91.9% respectively and positive predictive values were 8,11,0.Conclusions Taking 400 days as the upper DTs'value for malignancies has important diagnostic value. Computer-aided diagnosis with three-dimensional volumetric measurement is sensitive to the volume changes of solid pulmonary nodules on follow-up CT, and is useful in the differential diagnosis of pulmonary nodules.

Objective To discuss the liver function recovery affected by the portal vein flow in patients who underwent adult-to-adult living donor liver transplantation using the right lobe. Methods Seventy-four donors and recipients were included in this study. Intraoperative Doppler ultrasound (IOUS)were performed before splitting the donor liver and 1 hour after the graft reperfusion. The diameter and velocity of portal vein were measured and recorded for calculation of portal vein flow(PVF). Liver function tests were undertaken at the day 2nd,7th, 15th and 30th postoperative,respectively. Results One hour after reperfusion of 74 grafts,the PVF were significantly increased (2. 84 ± 0. 93) fold. Seventy-four grafts were divided into 4 groups according to the different degrees of the increase of PVF. The levels of blood bilirubin total(TBIL) among 4 groups were differently at the day 2nd,7th, 15th and 30th postoperative. High PVF contributed to recipient's prolonged hyperbilirubinemia ( P ＜0. 001 ). The levels of ALT, AST among 4 groups were differently at the day 7th, 15th and 30th postoperative( P ＜0. 001). Conclusions Detection of portal vein hemodynamics in living donor liver transplantation by IOUS may assist surgeon to anticipate the graft's function and take surgical therapies to secure the graft and the recipient.

Objective this research mainly analysis in the treatment of patients with ischemic cerebrovascular disease by comparison of clinical therapeutic effect of endovascular treatment and simple drug treatment. Methods 60 cases of patients with ischemic cerebrovascular disease admitted in our hospital from January 2016 to January 2017, and were randomly divided into control group and observation group, 30 cases in each group. The control group were treated by endovascular treatment, the observation group were treated with simple drug treatment, the two groups of patients treated for 6 months, 12 months to improve blood flow, the incidence of cerebrovascular events, mortality, prognosis Quality of life scores as a comparison basis.Results The patients in the observation group were treated for 6 months, 12 months after the blood flow improved superior to the patients in the control group (P<0.05); the patients in the observation group were treated for 6 months, 12 months of cerebrovascular disease incidence rate lower than that of the control group (P<0.05); the observation group after 6 months treatment and mortality of patients in the control group had no significant difference; the patients in the observation group after 12 months of treatment the mortality rate lower than that of the control group (P<0.05). The patients in the observation group survival quality scores were excellent in the control group (P<0.05). Conclusion The study proves that, in the treatment of patients with ischemic cerebrovascular disease in the treatment can effectively improve the treatment effect of endovascular intervention, improve the blood flow status of patients, reduce the events in patients with cerebrovascular disease incidence and mortality.

Objective To investigate and analyze the effect of pantoprazole and omeprazole in the treatment of gastric ulcer.Methods a total of 100 patients with gastric ulcer treated in Shizuishan First People's Hospital from January 2014 to June 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group.The control group was treated with omeprazole, and the experimental group was treated with pantoprazole.After taking one course of treatment, the clinical efficacy, treatment cost, eradication rate of Helicobacter pylori and recurrence rate of gastric ulcer were compared between the 2 groups.Results The total effective rate of the experimental group was 94%, which was significantly higher than that of the control group(72%), and the difference was statistically significant(P<0.05).After the corresponding treatment, the experimental group of 50 cases, Helicobacter pylori eradication rate was 72%, the recurrence rate of gastric ulcer was 12%.In the control group of 50 cases, the eradication rate of Helicobacter pylori was 52%, and the recurrence rate of gastric ulcer was 36%.As a result, the eradication rate of H.pylori in the experimental group was significantly higher than that in the control group.The cost of treatment in the control group was(499.78±74.81)yuan, and the treatment cost of the experimental group was(413.26±56.39)yuan.The treatment cost and gastric ulcer recurrence rate in the control group were significantly higher than those in the experimental group, with statistical difference(P<0.05).Conclusion Pantoprazole in the treatment of gastric ulcer is much better than omeprazole, high treatment efficiency, is the preferred drug for the treatment of gastric ulcer, after the treatment of gastric ulcer recurrence rate is low, the cost of treatment is low and high eradication rate, with the further promotion and application in clinic significance.

Objective To explore the influence of no drainage on pelvic lymphocyst following laparoscopic radical hysterectomy and pelvic lymphadenectomy . Methods A total of 105 patients with cervical cancer undergoing laparoscopic radical hysterectomy and pelvic lymphadenectomy in this hospital from January 2012 to February 2016 were divided into either non-drainage group (50 cases) or drainage group (55 cases) according to whether the pelvic drainage tube was placed after surgery .Comparative analyses on the incidence of postoperative complications such as pelvic lymphocyst were made between the two groups . Results No significant difference in lymphocyst rate was found between the two groups [27.3%(15/55) vs.24.0%(12/50), χ2 =0.147, P=0.702].The incidence of pelvic infection was lower in the non-drainage group (2.0%, 1/50) than that in the drainage group (14.5%, 8/55), but the difference was not statistically significant (χ2 =3.781, P=0.052).Other postoperative complications including urinary retention , urinary fistula, and deep venous thrombosis of lower limb had no statistical differences between the two groups (P>0.05). Conclusions Drainage after radical hysterectomy and pelvic lymphadenectomy for cervical cancer does not make a difference to the incidence of lymphocyst .Non-drainaging doesn ’ t increase the risk of infection .

Humans ; Industry ; Occupational Exposure ; classification ; Occupational Health ; Reference Standards

Cystic Adenomatoid Malformation of Lung, Congenital ; diagnostic imaging ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant, Newborn ; Lung ; diagnostic imaging ; pathology ; Male ; Pneumonectomy ; Tomography, X-Ray Computed

Objective To investigate the quantitative analysis of tissue diffusion of real-time elastography(RTE) in chronic renal allograft injury(CRAI) and the relationship between RTE and the level of serum creatinine(Cr).Methods Sixty-nine cases of allograft renal transplantation patients were detected by conventional ultrasound and RTE.According to the time after operation and Cr,they were divided into three groups:group A (in three months after operation and normal Cr,25 cases),group B (more than three months after operation and normal Cr,23 cases),and group C (more than three months after operation and high Cr,21 cases).The results were compared and analyzed.Results ①Contrast between group A and group B,there were differences on Cr and average ralative strain value(MEAN),area ratio of low-strain region (％ AREA),complexity (COMP),skewness (SKEW),(P ＜ 0.05).② In group B,there was correlation between Cr and ％AREA,MEAN,SKEW (r =0.682,P ＜0.05; r =0.628,P ＜0.05; r =-0.481,P ＜0.05).③To make ROC curve,MEAN has higher sensitivity (90.9％),COMP has higher specificity and accuracy (68.0％,81.8％).④ To apply the third result in group C,4 or 5 cases in 21 were abnormal.Conclusions There is a good correlation between the quantitative analysis of tissue diffusion and the level of serum creatinine.RTE can indirectly reflect CRAI,and it is a new method of ultrasonic to evaluate renal allograft function.

Objective To observe the efficacy, safety and feasibility of the four kinds of anticoagulation method in hemodialysis patients with high risk of hemorrhage. Methods 128 patients with high risk of hemorrhage who had undergone hemodialysis were randomly divided into four groups. In group A, 68patients were resorted with 30% regional sodium citrate anticoagulation(RCA). In group B, 60 patients were treated with local heparin anticoagulation. In group C, 64 patients were treated with low molecular weight heparin (LMWH). In group D, 66 patients received no heparinization hemodialysis. The changes of bleeding, clotting function, adverse effect and nursing strategies were studied. Results All patients of group A completed regular hemodialysis with satisfactory indices, 6 cases with bleeding and primary bleeding aggravated in group B, 8 cases with bleeding and primary bleeding aggravated in group C, 8 cases occurred grade three coagulation and finished dialysis in group D. 3 cases in group A and 2 cases in group B occurred adverse reaction, but no adverse reaction was seen in group C and D. Conclusions RCA is safe,effective and can be easily handled in regular hemodialysis. It is an ideal dialysate for hemodialysis in patients with high risk of hemorrhage.

Objective:To investigate the influence of lumbar disc degeneration on the efficacy of lumbar fixed-point rotation manipulation in sitting position in treating lumbar intervertebral disc herniation (LIDH). Methods:We simulated lumbar fixed-point rotation manipulation of sitting position using three finite element models including a normal model, a mild degeneration model and a moderate degeneration model of L3-5, in which the herniated disc was assumed at the left rear of L4 disc and the rotation manipulation was carried out on the right side. The displacement and stress at the left rear of L4 disc of the three models were analyzed. Results:When lumbar fixed-point rotation manipulation in sitting position was carried out, a displacement and stress were generated at the left rear of L4 intervertebral disc of the three models directing forward. The displacement and stress in degeneration models were less than those in the normal model, and the smallest values were found in the moderate degeneration model. From normal model to mild and then to the moderate degeneration model, the displacement decreased by 36% and 59%, and the stress decreased by 22.3% and 45.2%, respectively. Conclusion:The lumbar disc degeneration affects adversely the effectiveness of lumbar fixed-point rotation manipulation in sitting position in the treatment of LIDH. The severer the lumbar degeneration, the greater the influence.