Carcinoma, Hepatocellular ; pathology ; therapy ; Humans ; Liver Neoplasms ; pathology ; therapy ; Neoplasm Metastasis ; Neoplasm Recurrence, Local

Carcinoma, Hepatocellular ; Humans ; Liver Neoplasms

China ; Combined Modality Therapy ; Evidence-Based Medicine ; Humans ; Liver Neoplasms ; diagnosis ; pathology ; prevention & control ; therapy ; Medicine, Chinese Traditional ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Remission Induction ; Survival Rate

The development of digestive endoscopy has played a very important role in promoting diagnosis and treatment for digestive system diseases in children. Electronic endoscopy is safe and simple for check and treatment. If applied to chronic diarrhea it will extensively improve the diagnosis and therapy efficacy.

Enteral nutrition (EN) therapy is one of the most important treatments of Crohn's disease (CD),especially in European countries,EN is considered as the first-line of treatment for pediatric CD.EN can improve the poor nutrition condition,induction and maintenance remission,the risk of this treatment is very low.But in our country the application of EN is still limited,deepening the understanding and obtained clinical guidelines are very important.

Humans ; Integrative Medicine ; trends ; Medical Oncology ; trends ; Medicine, Chinese Traditional ; trends ; Neoplasms ; therapy

OBJECTIVETo observe the effect on female stress urinary incontinence (SUI) treated with the pudendal nerve stimulation of electroacupuncture therapy at different frequencies.

METHODSSixty patients were divided into a group treated three times every week (group A) and a group treated twice every week (group B), 30 cases in each one. The pudendal nerve stimulation of electroacupuncture therapy was adopted at Disixue (four acupoints on sacral region), 60 min in each time in the two groups, treated three times a week or twice a week respectively. SUI severity and the score of life quality were observed before and after 12 treatments separately. The efficacy was evaluated in the two groups.

RESULTSAt the end of treatment, SUI severity was relieved and the score of life quality was improved in the two groups (all P<0.01). The results in group A were superior to group B [0 (0-4.3) vs 4 (0-5), P<0.01]. At the end of treatment, the total effective rate in group A was 90.0% (27/30) and was 76.7% (23/30) in group B; the efficacy in group A was better than that in group B (P<0.05).

CONCLUSIONThe pudendal nerve stimulation of electroacupuncture therapy achieves the definite efficacy on female SUI and the results in the treatment of three times a week are superior to those in the treatment of twice a week.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Middle Aged ; Quality of Life ; Treatment Outcome ; Urinary Incontinence, Stress ; psychology ; therapy

Humans ; Pancreatitis, Acute Necrotizing ; diagnosis ; therapy ; Practice Guidelines as Topic

BACKGROUND: Biliary complications are the common complication of liver transplantation. However, it is difficult to find the complications, since no obvious characteristic signs on the patients. Magnetic resonance imaging (MRI), especially,magnetic resonance cholangiopancreatography (MRCP) may provide a comprehensive evaluation of the functions and complications of the transplanted liver as a safe, noninvasive and exact technique.OBJECTIVE: To evaluate the manifestation of biliary system after liver transplantation by MRCP and its value of diagnosis of biliary complications.DESIGN: Comparative observation.SETTING: Medical Imaging Center, Nanfang Hospital, Southern Medical University.PARTICIPANTS: A total of 13 male liver transplantation patients aged from 40-58 years, who received imaging examination at Medical Imaging Center, Nanfang Hospital, Southern Medical University from January 2003 to January 2005, were enrolled. Original causes of liver failure included cirrhosis (n =11) and primal hepatic carcinoma (n =2). Ten received orthotopic liver transplantation, while 3 received piggyback orthotopic liver transplantation. Anastomotic mode of bile duct was common bile duct end-to-end anastomosis. The interval between transplantation and MRI examination ranged from 15 days to 1 year. All patients knew the items of examination and agreed to participate in the experiment.METHODS: Thirteen patients with orthotopic liver transplantation underwent turbo spin-echo (TSE) and fast low angle shot (FLASH), MRCP, Gd-DTPA enhanced MRI to analyze the characteristics of each imaging after liver transplantation.MAIN OUTCOME MEASURES: The imaging findings of the reestablished bile duct and complications of bile duct at MRCP.RESULTS: The diameters of bile duct and caliber were normal, no stricture on anastomotic stoma in 3 patients.Thick-section planes of MRCP did not develop biliary duct of one case. Biliary dilation occurred in 8 patients. There were 5 cases of biliary strictures and 2 cases of choledochus stone. Mucocele of bile duct remnant was identified in 2 cases.Bile leakage occurred in 1 case after T-tube was removed. Rejection reaction occurred in 2 cases.CONCLUSION: MRCP not only can display the image of reestablished biliary tract after liver transplantation, but also can exactly diagnose complications rapidly.

BACKGROUND: Sonography is believed by many scholars to be sensitive for the detection of hepatic arterial thrombosis and stenosis, but it is difficult to show the anastomotic vascular stenosis. MR angiography is better than sonography in the display of vascular anatomy and the diagnosis of various vascular complications after liver transplantation.OBJECTIVE: To evaluate the role of MR angiography (MRA) in the display of vascular anatomy and the diagnosis of various vascular complications after liver transplantation.DESIGN: Contrast trial observation.SETTING: Medical Imaging Center of Nanfang Hospital, Southern Medical University.PARTICIPANTS: Eleven adult male patients had undergone liver transplantations at Nanfang Hospital of Southern Medical University between January 2004 and December 2006. They ranged in age from 40 to 58 years, average 49 yeas. Original causes of liver failure in the study group included cirrhosis (n =9) and primal hepatic carcinoma (n =2) diagnosed by pathohistological methods. And 9 cases had undergone orthotopic liver transplantations while 2 cases with piggy-back liver transplantation.METHODS: Eleven consecutive adult patients underwent MR imaging examinations after orthotopic liver transplantation using a breath-hold 2D True Fast Imaging with Stead-state Precession and Fast Low Angle Shot. MR triphasic contrast-enhanced 3D imaging was also performed. Enhancement scan: A final gadolinium-enhanced axial and coronal T1WI spin-echo sequence with spectral fat saturation was performed after completion of the MRA. The vascular diameter stenosis was calculated according to S (S=[(D-d)/D]×100%) by ECST method, d as the inner diameter of the most obvious stenosis while D as normal diameter. Degree of stenosis: normal as S 0-30%, mild stenosis as S 31%-50%, moderate stenosis as S 51%-85%, and severe stenosis as S 86%-100%. Then the imaging findings after liver transplantation were analyzed. Meanwhile the sonography was performed.MAIN OUTCOME MEASURES: ① MR Image analysis of vascular anatomy and vascular complications after liver transplantation.②Normal findings after liver transplantation by using sonography.RESULTS: All 11 patients were involved in the result analysis.①MRA: The anastomosis of hepatic artery, portal vein and inferior vena cava were smooth in 3 cases. The high signal intensity was seen around portal vein at T2WI in 1 case with a shorter interval after transplantation and persisted 3 weeks. In 1 case, the caliber of the donor portion was smaller than the recipient portion. Among other 8 cases, hepatic artery complication included hepatic artery winding in 2 cases and aneurysm formation of donor's hepatic artery in 2 cases, but the twig of the hepatic artery was normal. Mild Portal vein stenosis at the anastomosis was found in 2 cases, caused by the different calibers of the donor portion from the recipient portion, but the inter-hepatic branches of the portal vein were normal. Clubbed dilatation of hepatic veins end-brush was depicted in 2 cases whose inferior vena cava at the anastomosis was not stenosis. Inferior vena cava thrombosis was found in 1 case. The thrombus displayed the low signal intensity in the high signal intensity of inferior vena cava. By follow-up examination, the degree of clubbed dilatation of hepatic veins end-brush reduced after half a year and inferior vena cava thrombosis disappeared by treatment. ②Sonography: By ultrasound examination, 1 case who had hepatic artery winding combining to aneurysm formation of donor's hepatic artery was discovered just hepatic artery winding. In 2cases that had mild portal vein stenosis at the anastomosis, 1 case was diagnosed normal while the other was not affirmed. The clubbed dilatation of hepatic veins end-brush was not depicted. The others were same as MRI diagnosis.CONCLUSION: Dynamic enhanced 3D MRA imaging can provide a comprehensive assessment of vascular anatomy in most recipients of liver transplants, and is an accurate and quick method to diagnose the vascular complication after liver transplantation.