Objective: To analyze and compare the imaging characteristics of contrast-enhanced ultrasound (CEUS) and dynamic enhanced magnetic resonance imaging (MRI) for diagnosis of peripheral intrahepatic cholangiocarcinoma, aiming to increase the accuracy of diagnostic imaging. Methods: The imaging characteristics of CEUS and dynamic enhanced MRI in 51patients with peripheral intrahepatic cholangiocarcinoma confirmed by surgical pathology or fine needle aspiration biopsy were retrospectively analyzed and compared. Results: Fifty-five lesions in fifty-one cases were analyzed. On CEUS, the hyperenhancement in arterial phase was seen in all 55 lesions, iso-echo in 8 lesions and hypo-echo in 47 lesions in portal phase, and hypo-echo in all 55 lesions in delayed phase. On enhanced MRI, all 55 lesions displayed the same characteristics as CEUS in arterial phase except 44 lesions continuously displaying hyper-intensity and 11lesions displaying hypo-intensity in portal and delayed phases. On CEUS, 42 (76.4%) lesions displayed rim-like enhancement, and 13 (23.6%) lesions displayed gross enhancement. During the process of enhancement, the pattern of branch-like extending inwardly was observed in 40 (72.7%) lesions. On dynamic enhanced MRI, 40 (72.7%) lesions showed the pattern of rimlike enhancement, and other 15 (27.3%) lesions showed gross enhancement. The features of CEUS were rim-like enhancement in arterial phase with branch-like extending inwardly. A large proportion of the lesions displayed heterogeneous enhancement when reaching the peak intensity. The characteristics of dynamic enhanced MRI were similar to CEUS in arterial phase, but a continuous enhancement was seen in portal and delayed phases, indicating enhancement in late phase. The occurrence rate of characteristic manifestation on CEUS was 70.9% (39/55) according to the standard of "fast-in and fast-out" and "rimlike" and/or "branch-like" enhancement. The occurrence rate of characteristic manifestation on dynamic enhanced MRI was 69.1% (38/55) according to the standard of "rim-like enhancement" in arterial phase and "delayed enhancement" in late phase. There was no difference in the occurrence rate of characteristic manifestation between CEUS and dynamic enhanced MRI (P = 1.000). Conclusion: The characteristic manifestations on CEUS and dynamic enhanced MRI for the diagnosis of peripheral intrahepatic cholangiocarcinoma display a high diagnostic value.

Objective: To evaluate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of subcapsular small liver cancer. Methods: Fifty-one patients diagnosed with subcapsular liver cancer by ultrasound or other imaging between January 2017 and July 2019 were enrolled. The manifestations of conventional ultrasound and contrast-enhanced ultrasonography were analyzed, and the characteristics, summarized. Results: There were a total of 53 lesions, all of which were confirmed on the basis of surgical findings, clinical manifestations, or imaging findings. All lesions were located under the liver capsule. Forty-five lesions were located close to the liver capsule, whereas 8 lesions were located within 10 mm from the liver capsule. Of the subcapsular lesions, 90.6% (48/53) were isoechoic and slightly higher or lower echoic, and 94.3% (50/53) had unclear boundaries. CEUS revealed rapid arterial enhancement in 48 of 53 lesions and synchronous enhancement in 5 lesions. In the portal phase, 38 lesions (71.7%) presented hypoechoic changes, and 15 lesions presented isoechoic changes. In the delayed phase, 50 lesions (94.3%) presented hypoechoic changes, and 3 lesions presented isoechoic changes. Among the 53 lesions, the "fast in and fast out" type was found in 38 cases (71.7%) and the "fast in and slow out" type, in 12 cases (22.6%). There were also 3 cases (5.7%) of "fast in and no out" type. Conventional ultrasound revealed 15 lesions, with a detection rate of 28.3% (15/53), and contrast-enhanced ultrasound revealed 53 lesions, with a detection rate of 100% (53/53). The difference between the two methods was statistically significant (P<0.01). Conclusions: Contrast-enhanced ultrasound has a high detection rate for subcapsular small liver cancer and has a significant clinical value.

Limited by the imaging principle of whole body bone SPECT image, the gray value of bladder area is quite high, which affects the image's brightness, contrast and readability. In the meantime, the similarity between bladder area and focus makes it difficult for some images to be segmented automatically. In this paper, an improved Snake model, GVF Snake, is adopted to automatically segment bladder area, preparing for further processing of whole body bone SPECT images.
Algorithms ; Bone and Bones ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; Models, Anatomic ; Tomography, Emission-Computed, Single-Photon ; methods ; Urinary Bladder

OBJECTIVETo observe the effect of Qinwen Baidu Decoction (QBD) in treating snake bite induced dissseminated intravascular coagulation (DIC).

METHODSForty-six patients were randomly divided into the control group (n = 16) and the treated group (n = 30). They were all treated with the conventional therapy, including application of anti-snake venom serum and supplement of blood agglutination factors. For the treated group, QBD was administered additionally. The efficacy of treatment, chief indexes for DIC (platelet, fibrinogen and prothrombin time) and their recovery time, etc. were observed.

RESULTSThe total effective rate of the treated group was 93.33%, which was higher than that of the control group (56.35%), and the recovery time of chief DIC indexes in the treated group was significantly shorter than that in the control group respectively (P < 0.01).

CONCLUSIONQBD shows obvious effects of shortening therapeutic course and enhancing efficacy in treating snake bite induced DIC.

Adolescent ; Adult ; Combined Modality Therapy ; Disseminated Intravascular Coagulation ; drug therapy ; etiology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immune Sera ; Male ; Middle Aged ; Phytotherapy ; Single-Blind Method ; Snake Bites ; complications ; drug therapy ; Snake Venoms ; immunology

Objective: To evaluate the feasibility of quantitative analysis of dynamic 3-dimensional contrast-enhanced ultrasound (3D-CEUS) for treatment effects of microwave coagulation on xenograft tumors in nude mice. Methods: BALB/c nude mice transplanted of HepG2 cells were divided into treatment group(n=16) and control group(n=16). The tumors were treated by incomplete microwave coagulation in the treatment group when their maximum diameters were about 0.8~1.0 cm. The baseline ultrasound and dynamic 3D-CEUS were performed on 1 d before treatment, 3 d after treatment, 7 d after treatment and 14 d after treatment. Time-intensity curves of the tumors were obtained by fitting. The quantitative parameters were also obtained, including peak intensity (PI), time to peak (TTP), mean transit time (MTT), slope (S), area under the curve (AUC), area under the curve of wash-in (AWI), and area under the curve of wash-out (AWO). Results: There were significant differences(P=0.029) between the two groups in PI, S, AUC, AWO on 3 d and 14 d. The differences in other parameters were not statistically significant (P>0.05). On 1 d before treatment and 7 d after treatment, none of the parameters had statistically significant difference (P>0.05). Conclusions The quantitative analysis of dynamic 3D-CEUS is feasible to assess the treatment response on xenograft tumors in nude mice.

OBJECTIVETo evaluate the value and clinical effect of peripheral aneurysms with polytetrafluoroethene (PTFE) stent graft after peripheral endovascular procedures.

METHODSFrom May 2012 to November 2013, 13 patients of peripheral aneurysms were treated with PTFE stent graft. There were 9 male and 4 female patients, aged from 24 to 74 years with a mean of 52 years. There were 7 aneurysms and 6 pseudoaneurysms. This stent graft was a self-expanding nitinol stent, internally covered by an ultra-thin polytetrafluoroethene (PTFE) graft. All peripheral aneurysms were repaired with the PTFE stent graft, using an entirely percutaneous approach. All patients were given clopidogrel and (or) aspirin postoperatively. Complications and reintervention rates were also examined.

RESULTSPTFE stent graft placement was successfully performed in all the 13 cases, and the instant isolation effect was quite satisfactory. During the follow-up period of 3 to 18 months, no stent graft related complications occurred in all patients except one patient with iliac arterial pseudoaneurysm, who developed pseudoaneurysms presented as a complication at puncture site. There were no other symptomatic complications with graft patience.

CONCLUSIONEndovascular repair can be considered as an effective treatment strategy for peripheral aneurysms by PTFE stent graft.

Adult ; Aged ; Aneurysm ; surgery ; Drug-Eluting Stents ; Endovascular Procedures ; Female ; Fluorocarbons ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Polymers ; Treatment Outcome

OBJECTIVETo investigate clinicopathological features and prognostic factors of appendiceal neuroendocrine neoplasms(a-NEN).

METHODSClinical data of 20 patients diagnosed with a-NEN at Zhongshan Hospital of Fudan University between January 2000 and December 2016 were retrospectively analyzed. Pathological diagnosis was based on the WHO classification criteria of digestive system tumors (2010 edition). Based on the mitotic count and Ki-67 index, a-NENs were divided into grade 1 neuroendocrine tumor (NET G1), grade 2(G2) NET G2) and grade 3 (neuroendocrine carcinoma, NEC). Some special types of a-NEN (e.g. goblet cell carcinoid) and mixed adenoneuroendocrine neoplasms were classified as mixed adenoneuroendocrine carcinoma (MANEC). Follow-up was conducted by telephone or return visits. Univariate analysis was carried out using the Kaplan-Meier method, and the log-rank test was used to draw survival curves.

RESULTSOf 20 patients, 14 were male and 6 were female with median age of 54 years. Seventeen cases presented acute right lower quadrant abdominal pain, 1 chronic right lower quadrant abdominal pain, 1 persistent abdominal discomfort with outburst whole abdominal pain and 1 was found during body check without symptoms. Twenty cases comprised 8 G1 patients, 4 G2 patients, 3 G3 patients, and 5 MANEC patients. When diagnosed, there was 1 patient with liver metastasis, 1 patient with abdominal and pelvic metastases, and 2 patients with postoperative pathological findings of lymph node metastasis. Six patients underwent appendectomy, 12 underwent right hemicolectomy, 1 underwent right hemicolectomy plus small intestine resection, and 1 underwent partial hepatectomy plus right hemicolectomy. The follow-up time was 7-187 months(average, 36 months). The total 1- and 3-year survival rates were 94.7% and 60.2%, respectively. Univariate analysis showed that age >50 years (χ=7.036, P=0.008), pathology grade as MANEC (χ=5.297, P=0.021), and metastasis (χ=6.558, P=0.010) indicated lower 5-year survival rate.

CONCLUSIONSMost a-NEN patients have no typical symptoms, and the main complaint at consultation is acute right lower quadrant abdominal pain. Prognosis is poor for patients with age >50 years, MANEC pathology grade and metastasis.

Appendiceal Neoplasms ; complications ; diagnosis ; surgery ; Carcinoma, Neuroendocrine ; complications ; diagnosis ; therapy ; Female ; Gastrointestinal Neoplasms ; Humans ; Male ; Middle Aged ; Neuroendocrine Tumors ; complications ; diagnosis ; surgery ; Prognosis ; Retrospective Studies

OBJECTIVETo study the influence of glucose-6-phosphate dehydrogenase (G6PD) deficiency on hand-foot-mouth disease (HFMD) induced by enterovirus 71 (EV71) , and possible mechanisms.

METHODSA total of 220 boys with HFMD induced by EV71 were classified into two groups based on disease severity: mild/moderate (n=145) and severe HFMD groups (n=75), and 132 healthy boys were selected as the control group. The activity of G6PD and levels of reduced glutathione (GSH) and malonaldehyde (MDA) in blood were measured using the automatic biochemical analyzer.

RESULTSThe percentage of G6PD deficiency cases in the severe HFMD group was significantly higher than in the control group (P<0.0125). In the severe HFMD group, the durations of fever, mental abnormality, limb trembling and hospital stay were significantly longer in children with G6PD deficiency than in those with normal G6PD activity (P<0.05). In the acute and recovery stages, patients in the mild/moderate and severe HFMD groups had significantly lower GSH levels and G6PD activity and significantly higher MDA levels compared with those in the control group (P<0.05). In the acute stage, children in the mild/moderate and severe HFMD groups with G6PD deficiency had significantly lower GSH levels and significantly higher MDA levels compared with those with normal G6PD activity (P<0.01). In the acute and recovery stages, GSH level in children with HFMD was positively correlated with G6PD activity (r=0.61, P<0.01; r=0.58, P<0.01), and in the acute stage, MDA level was negatively correlated with G6PD activity (r=-0.29, P<0.01).

CONCLUSIONSG6PD deficiency is probably a predisposing factor for HFMD induced by EV71 and may aggravate the patient's condition. Its mechanism might be related to oxidative stress.

Child, Preschool ; Enterovirus A, Human ; Glucosephosphate Dehydrogenase ; blood ; Glucosephosphate Dehydrogenase Deficiency ; complications ; Glutathione ; blood ; Hand, Foot and Mouth Disease ; etiology ; Humans ; Infant ; Male ; Malondialdehyde ; blood

OBJECTIVETo investigate the causes of unintentional injuries in children and to provide reference for reducing the incidence of unintentional injuries in children.

METHODSA retrospective analysis was performed on the clinical data of 924 children with unintentional injuries who were hospitalized in Zhongshan Boai Hospital from January 2008 to December 2010.

RESULTSOf the 924 cases, 26.4% suffered falls, which was the most common cause of injuries, 15.7% suffered burns and scalds, 14.0% were injured by foreign bodies, and 13.1% were injured in traffic accidents. Unintentional injuries occurred mainly among children aged 0-3 years (67%). The proportion of cases in summer (July to September) was significantly higher than in any other season (P < 0.05), and burns were the common causes of injuries in summer. Home was the most common place where unintentional injuries occurred (36.9%). The incidence of traffic accidents was significantly higher in non-local children than in local children (P < 0.001). As for the parents' educational levels, the children whose parents had an education level below junior middle school accounted for the highest proportion of all cases of unintentional injury (45.5%). Injuried cases in rural areas accounted for a significantly higher percentage than in urban areas (P < 0.05).

CONCLUSIONSFalls are the principal cause of unintentional injuries in children. Young children (0-3 years) are most vulnerable to unintentional injuries. Unintentional injuries mostly occur at home. The incidence of traffic accidents is higher in non-local children than in local children. Parents' education levels are associated with the incidence of unintentional injuries. In order to reduce the incidence of unintentional injuries in children, preventive measures must be carried out, and safety education should be enhanced in consideration of children's age, sex and family background.

Accidents ; statistics & numerical data ; Adolescent ; Child ; Child, Preschool ; Educational Status ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Parents ; Retrospective Studies

OBJECTIVETo study the risk factors for moderate and severe iron deficiency anemia (IDA) in infants aged 6-12 months, and to preliminarily investigate the effects of IDA on the neuromotor development and temperament characteristics of infants.

METHODSA total of 326 infants aged 6-12 months with IDA were classified into three groups: mild IDA (n=176), moderate IDA (n=111), and severe IDA (n=39) according to the severity of anemia. The risk factors for moderate or severe IDA were investigated by multivariate logistic regression analysis. Three hundred and forty-six infants without IDA who showed matched age, sex, and other backgrounds were selected as the control group. The Gesell Development Diagnosis Scale was used to evaluate children's mental development. The Temperament Scale for infants was used for evaluating children's temperament.

RESULTSThe univariate analysis showed that the severity of IDA was associated with sex, birth weight, gestational age, multiple birth, maternal anemia during pregnancy, and mother's lack of knowledge about IDA (P<0.05). Setting the mild IDA group as control, the multivariate logistic regression analysis showed that multiple birth, premature birth, low birth weight (<2500 g), maternal anemia during pregnancy, breast feeding, and mother's lack of knowledge about IDA were the risk factors for severe IDA (OR>1; P<0.05); premature birth, breast feeding, and mixed feeding were the risk factors for moderate IDA (OR>1; P<0.05). The IDA group had significantly lower scores in Gesell general development quotient, gross motor, adaptive behavior, and fine motor than the control group (P<0.05). The IDA group had higher percentages of children with difficulty and intermediate difficulty temperaments than the control group (P<0.05). The IDA group had significantly higher scores in activity level, rhythmicity, adaptability, and perseverance than the control group (P<0.05).

CONCLUSIONSThe severity of IDA is associated with premature birth, multiple birth, low birth weight, feeding pattern, maternal anemia during pregnancy and mother's lack of knowledge about IDA in infants aged 6-12 months. Infants with IDA have delayed neuromotor development and most of them have negative temperaments. More attention should be paid to mental and behavior problems for the infants. It is necessary to provide guidance for their parents in feeding and education.

Anemia, Iron-Deficiency ; etiology ; Child Development ; Female ; Humans ; Infant ; Infant, Low Birth Weight ; Logistic Models ; Male ; Psychomotor Performance ; Risk Factors