1.Features of multi-slice spiral computed tomography examination of mesenteric panniculitis
Chinese Journal of Digestive Surgery 2017;16(6):624-628
Objective To summarize the features of multi-slice spiral computed tomography (MSCT) examination of mesenteric panniculitis (MP).Methods The retrospective cross-sectional study was conducted.The clinical data of 105 patients with MP who were admitted to the Yangzhou NO.1 People's Hospital between September 2009 and September 2015 were collected.All the patients were diagnosed by MSCT and multiplanar reconstruction (MPR).Observation indicators:(1) imaging features of computed tomography (CT):location,number,shape,size,density,mesenteric vessels and surrounding intestine of the lesions,with or without pseudotumor sign,enlarged fibrous nodules or lymph nodes,pseudocapsule sign,fatring sign,cystolization and calcification;(2) follow-up results.Follow-up using outpatient examination was performed by plain and/or enhanced scans of abdominal CT up to April 2017.Results (1) Imaging features of CT:of 105 patients,77,14 and 14 received respectively plain scans of abdominal CT,plain and enhanced scans of abdominal CT and enhanced scans of abdominal CT.Lesions of 105 patients were located at the mesentery.The single lesion was detected in 79 patients and multiple lesions in 26 patients,with number of lesions of 5-12 per case and total number of 213.All the 105 patients had pseudotumor sign,which showed different size of patchy or mass shadows with clear edge extended from mesentery root to mesenteric vessels;most long axes extended from mesentery root to jejunum in the left lumbar region;the homogeneous or heterogeneous mesenteric fat density was increased,and CT value was higher than that of normal retroperitoneal adipose tissues;fog-like mesentery showed less obvious enhancement by enhanced scan and mesenteric vessels were wrapped around.The cord-like,round or oval fibrous tissue nodules and/or enlarged lymph nodes were found in 100 patients.All the 105 patients had pseudocapsule sign.The density ring of soft tissues of different thickness was found,with a clear boundary between leading-and trail-edges and normal abdominal and retroperitoneal adipose tissues;most membranes extended to left lumbar region,thicker and thinner membranes were respectively located at the anterior and posterior areas and right side,and parts of membranes were absence.The fatring sign was detected in 71 patients,there were ring-like hypodense shadows around the mesenteric vessels and fibrous tissue nodules or lymph nodes.Cystolization and calcification were found in 2 and 2 patients.Thirty-eight patients had surrounding intestinal canal translocation.(2) Follow-up results:55 patients were followed up for 1.0-57.0 months,with an average time of 14.7 months.Of 55 patients,26 had stable lesions and no obvious changes;4 returned to normal due to complete absorption of lesions;19 were improved due to partial absorption of lesions;6 had lesions progressions.Conclusion The features of MSCT examination of MP include pseudotumor sign,pseudocapsule sign and fatring sign.
2.Minimally invasive managements for non-anastomotic biliary stricture after orthotopic liver transplantation
Shaoping WANG ; Yujian ZHENG ; Feng HUO
Chinese Journal of Digestive Endoscopy 2014;31(12):695-698
Objective To evaluate the clinical value of minimally invasive methods for non-anastomotic biliary stricture (NABS) after orthotopic liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation during recent 10 years in Liver Transplantation Center at General Hospital of Guangzhou Military Commanmol were analyzed retrospectively,and 13 patients with NABS were selected.The outcomes of 3 types of NABS patients treated by endoscopic retrograde cholangiopancreatography(ERCP) or percutaneous transhepatic cholangial drainage(PTCD) were compared and the indication for re-transplantation was identified.Results PTCD treatments of 4 patients were proved ineffective.The shortterm curative rate of minimally invasive treatments was 8/13.Five patients eventually required surgical treatments (re-transplantation in 4,Roux-en-Y anastomosis in 1).According to cholangiography results,NABS were divided into 3 types,namely hepatic bile duct strictures (n =4,type Ⅰ),multiple extra-hepatic and intrahepatic biliary strictures (n =7,type Ⅱ),intrahepatic biliary strictures (n =2,type Ⅲ).The success rates of minimally invasive treatment in 3 types of NABS were 3/4,4/7 and 1/2,respectively.Nearly half of type Ⅱ and type Ⅲ patients needed re-transplantation,which was more likely for those patients with hepatic artery stenosis (2/3).Conclusion NABS treated with minimally invasive methods are preferred.Based on the appearance of biliary stricture,type Ⅰ patients had the best prognosis.For those type Ⅱ and type Ⅲ patients who failed minimally invasive treatment,especially combined with hepatic arterial stenosis,surgical treatment should be timely,so as not to lose a chance for re-transplantation.
3.Features and clinical value of multi-slice spiral computed tomography examination of acute primary epiploic appendagitis
Litong WANG ; Yujian CAI ; Cheng LI
Chinese Journal of Digestive Surgery 2015;14(1):78-81
Objective To summarize the features of multi-slice spiral computed tomography (MSCT) examination of acute primary epiploic appendagitis,and investigate the clinical value of MSCT.Methods The clinical data of 19 patients with acute primary epiploic appendagitis who were admitted to the Yangzhou No.1 Hospital from December 2009 to March 2014 were retrospectively analyzed.All the patients received MSCT examination,and the data were transported to the work station for multiplanar reconstruction.The location,shape,size,density,peripheral performance and peritoneal thickening were observed.Results The foci of the 19 patients were located adjacent to the colon.One focus was adjacent to the cecum,4 were adjacent to the ascending colon,1 was adjacent to the hepatic flexure of the colon,6 were adjacent to the descending colon,and 7 were adjacent to the sigmoid colon.The shapes of the foci were similar to the oval or ring in 14 cases and similar to the flame in 5 cases.The diameters of the foci were 0.8-3.7 cm.The results of CT plain scan showed that the density of the foci was similar to that of the fat,and the CT value was-101--34 HU.The central density of the foci was lower,while the limbic density was higher.The results of CT enhanced scan showed a ring-like enhancement region in the foci,and the lesion was surrounded by slightly high-density inflammation.Point or linear slightly high-density shadows were detected at the center of the foci in 9 patients.The peritoneum was locally thickened in 14 patients.The colonic wall was locally thickened in 1 patient,and the pelvic effusion was detected in 5 patients.The results of CT reexamination of 4 patients showed that the inflammatory regions were reduced or disappeared,the mass shrank,nodulized or calcified.Conclusions MSCT examination can provide a specific features of primary epiploic appendagitis.It could accurately diagnose acute primary epiploic appendagitis when combined with multiplanar reconstruction.
4.The difference of mixing time and contamination rate between liquid and powder preparations EN
Xiurong, WANG ; Zhuming, JAING ; Baogui, WANG ; Yujian, NIU
Chinese Journal of Clinical Nutrition 2000;8(1):35-36
Objective To wmpare the differences of the mixing time and contamination rate between liquid and powder EN preparations. Methods 20 patients,receiving enteral nutrition for more than 6 days, were enrolled in. this study. They were randomized to receive either powder enteral diet (control group, n=10) or liquid enteral diet (study group, n=10). The mixing time was examed by stopwatch. The contamination rate was determined by culture of bacteria in the solution. Results 1. The mixing time of study group was significantly shorter than that of control group ( 18.9 ± 3.0 vs 106.0 ± 21.0 , P<0. 001). 2. The bacterial culture in both groups were negative before enteral feeding. There was no positive case in study group and only 2 positive eases in control group after infusion. However, there was no statistical difference between the two groups ( P=0.14). Conclusions Liquid form of enteral nutfitent was less time cost and no ease contaminated by enveriorment, but it is expensive. he ligurd preparation has more advantages than powdor one in mixing time and comtamination.
5.The incidence and risk factors of hyperuricemia after liver transplantation:a single-center retrospective study
Weiping RAO ; Yujian NIU ; Hongyu WANG ; Chun XU
Chinese Journal of Endocrine Surgery 2015;(6):493-496
Objective To analyze the incidence and related risk factors of hyperuricemia after liver transplantation.Methods A total of 286 cases undergoing liver transplantation from 2009 to 2012 in the Armed Police General Hospital , who had normal uric acid before transplantation and had been followed up for more than 1 year, were enrolled in this study.The clinical data, including liver and kidney function , blood glucose, and lipids were collected .The potential risk factors of hyperuricemia were analyzed .Results 53.5% cases ( 153/286)had hyperuricemia after transplantation.Hyperuricemic patients were predominately older (P =0.038). They also had a higher prevalence of increasing creatinine (P=0.000),and hyperlipidemia(P=0.000).Among female cases, hyperuricemic patients had a higher average BMI (P=0.027).Hyperuricemia group had an elevat-ed ratio of blood lipids 60.1%(92/153), higher than normal uric acid group (39.1%,52/133) ( P<0.05). Conclusions Liver transplantation recipients have a higher incidence of hyperuricemia , particularly in elderly and overweight female patients .Our findings suggest that postoperative hyperuricemia may be associated with high serum creatinine, elevated blood lipids.We should strengthen follow-up, take early detection and early treat-ment.
6.Application of the health belief model for liver transplant follow up: a prospective randomly controlled trial
Ying WANG ; Meixiong LIN ; Yujian NIU ; Li LI
Chinese Journal of Health Management 2011;05(4):204-206
Objective To investigate the effects of a newly developed health belief model (HBM)on the survival of liver transplant recipients. Methods The most important health concerns and follow-up service expectations were learned from out-patients who received long-term liver transplant follow up, and a new HBM for liver transplant was developed. The impact of the HBM on survival was evaluated in this prospective randomly controlled trial. Results In 374 liver transplant recipients who completed the questionnaire, the most common health concerns were the implication of follow-up service and optimal medications ,etc. Moreover,liver transplant club and improved role and function of health-care providers were expressed by the participants to enhance interactions with the medical staff. After 2 years' follow up, the incidence of abnormal liver function ( 16. 8% vs 21.2% ), infection ( 3.2% vs 10. 3% ) and disease recurrence (2. 6% vs 9. 8% ) were significantly decreased in the study group (n = 190) when compared with the control group ( n = 184) ( all P < O. 05 ). Conclusion Adverse health events could be reduced following the application of HBM for liver transplantation.
7.Diagnosis and management of non-anastomotic biliary stricture after liver transplantation
Shaoping WANG ; Yujian ZHENG ; Peng LI ; Feng HUO
Chinese Journal of Hepatobiliary Surgery 2014;20(8):577-581
Objective To study the diagnosis and treatment of non-anastomotic biliary stricture (NABS) after liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation in the past 10 years in our department were analyzed retrospectively,compared different methods to find out the most appropriate method in the diagnosis and management of NABS.Results NABS occurred in 13 out of 403 patients (3.2%),almost the same incidence as in patients who received DCD donor livers (4.16%,2/48).The clinical signs of NABS were frequent cholangitis and high TBil,r-GT and AKP (P <0.01).All these cases were finally diagnosed by cholangiography and they could be classified into 3 types:hepatic bile duct stricture (4 patients,type Ⅰ),multiple extrahepatic and intrahepatic biliary strictures (7 patients,type Ⅱ),intrahepatic biliary strictures (2 patients,type Ⅲ).NABS were mainly treated by interventional therapy,Roux-en-Y anastomosis and retransplantation in our centre.All type Ⅰ patients were successfully managed with interventional therapy/ERCP and Roux-en-Y anastomosis,but 44.4% (4/9) of type Ⅱ and Ⅲ patients required retransplantation.The TBIL,r-GT and AKP decreased significantly in 12 patients (P < 0.05) and the total curative rate of NABS was 92.3% (12/13) with one patient who died after retransplantation.Conclusions Cholangiography was an effective way to diagnose NABS which is common among patients after liver transplantation.Interventional therapy/ERCP,Roux-en-Y anastomosis and retransplantation were our 3 ways to treat this problem.We proceeded from easy to difficult and chose a suitable way to deal with NABS according to the different types of biliary stricture from cholangiography.Type Ⅰ patients had much better prognosis than Type Ⅱ and Ⅲ patients who should receive retransplantation if interventional therapy/ERCP failed.
8.Pre-existing intimal hyperplasia and expression of NF-κB and VCAM-1 in great saphenous veins in patients with coronary artery disease and diabetes mellitus
Wenqi LUO ; Wenjun ZHEN ; Huaibin WANG ; Jie TAN ; Yujian MA
Chinese Journal of Thoracic and Cardiovascular Surgery 2014;30(7):408-410,414
Objective To study the pre-existing intimal hyperplasia and the expression of nuclear factor-κB (NF-κB) and vascular cell adhesion molecule 1 (VCAM-1) in great saphenous vein(GSV) among the patients with diabetes mellitus undergoing coronary artery bypass grafting(CABG).Methods Segments of GSV were collected from 20 patients with diabetes mellitus and 22 patients without diabetes mellitus undergoing CABG.Morphometric analysis was performed after hematoxylin-eosin (HE) staining and Masson staining by microscopic computer analysis.Immunohistochemistry staining was used to examine the expression of NF-κB and VCAM-1 in intima.Results Pre-existing intimal hyperplasia was more common and server in GSV of the patients with diabetes mellitus.The expression of NF-κB and VCAM-1 were significantly higher in intima of GSV in patients with diabetes mellitus than patients without diabetes mellitus.The expression of VCAM-1 was positively related to NFκB in intima of GSV.Conclusion The pre-existing intimal hyperplasia and the expression of NF-κB and VCAM-1 were more common and server in GSV of the patients with diabetes mellitus than patients without diabetes mellitus.This can partially explain the poor prognosis of patients with diabetes mellitus after CABG.
9.Laparoscopic treatment of abdominal and retroperitoneal cystic masses in 11 children
Weize HU ; Yujian DAI ; Zhen LIU ; Tong YE ; Yingjun WANG
Chinese Journal of Applied Clinical Pediatrics 2021;36(1):54-58
Objective:To explore the feasibility and efficacy of laparoscopic resection of abdominal and retroperitoneal cystic masses in children.Methods:A retrospective analysis of 11 cases of abdominal and retroperitoneal cystic masses in Department of Pediatric Surgery, Quanzhou First Hospital Affiliated to Fujian Medical University from June 2015 to January 2019 was performed, and all the patients underwent laparoscopic resection or laparoscopic-assisted resection, with 6 cases of boys and 5 cases of girls, aged 8 months to 10 years (with the average of 59 months). Meanwhile, 9 cases were from the abdominal cavity and 2 cases were from the retroperitoneum.Results:All patients underwent laparoscopic or laparoscopic-assisted resection without switching to laparotomy.The operation time was 60-210 minutes, with the average of 120 minutes.The intraoperative blood loss was 5-30 mL, with the average of 10 mL.There was no blood transfusion.All patients were discharged 3-8 days after surgery, with the average of 5 days.The postoperative pathological results included 5 cases of mature teratoma, 1 case of paraneoplastic cyst, 2 cases of intestinal duplication, 2 cases of lymphangioma, and 1 case of hepatic cyst.Totally, 11 cases were followed up for 7-51 months, with the average of 20.9 months.No recurrence occurred.Conclusions:Laparoscopic or laparoscopic-assisted resection of abdominal and retroperitoneal cystic masses has advantages of minimal invasion, rapid recovery in children, and it is safe and effective.
10.Scientific papers published by public hospitals in Jilin Province and their research hot spots
Chuanbo KANG ; Wei CHEN ; Xiaomin MU ; Yujian ZHANG ; Jia WANG ; Wei WANG
Chinese Journal of Medical Library and Information Science 2016;25(10):69-75
Papers published by 70 public hospitals in Jilin Province from 2011 to 2015 were retrieved from CNKI, China Citations Database, and Wanfang Database. The scientific papers and their research hot spots were analyzed in aspects of the total number of published papers and different institutions-published papers, high output authors, cited papers, journals that published the papers, and foundation-supported papers in order to provide reference for subsequent research and policy-making.