1.The value of contrast-enhanced ultrasound in the diagnosis of small renal cell carcinoma and renal angiomyolipoma with minimal fat
Xiaojie XIN ; Sheng ZHANG ; Jie MU
Chinese Journal of Urology 2016;37(6):436-439
Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of small renal cell carcinoma (SRCC) and renal angiomyolipoma (AML) with minimal fat.Methods The images and data of conventional ultrasound (US) and CEUS were retrospectively reviewed in 47 cases of small renal cell carcinoma and 8 cases of AML with minimal fat (d < 30mm),which were confirmed by operation and pathologicall study,including 39 males and 16 females.The mean age of the patients was (54.8 ± 9.8) years old,ranged from 31 to 73 years old.The size,echo,boundary and color flow signals of renal lesions were observed by conventional US.Then the modality and phases of enhancement were observed,including the arrival time,the peak time,the washout time and the appearance of internal structures.Results On contrast-enhanced sonography,fast wash-in and wash-off were observed in most of SRCC,while slow wash-off were observed in most of RAML with minimal fat.The statistically significant differences were found between SRCC and RAML with minimal fat in the values of TFP (time a to peak) and PI (peak-intensity).The occurrence of round pseudo-capsule and contrast-enhancement characteristics in SRCC was far more often than RAML with minimal fat.Conclusions Contrast-enhanced sonography combined with time-intensity analysis provides more useful information for the diagnosis of SRCC and AML with minimal fat.
2.Multi-modality imaging in the diagnosis and differential diagnosis of small renal mass
Dai ZHANG ; Xiaojie XIN ; Sheng ZHANG ; Jie MU ; Ying WANG
Tianjin Medical Journal 2017;45(8):872-876
Objective To compare contrast-enhanced ultrasonography (CEUS), contrast-enhanced CT (CECT) and combined detection of two methods in the diagnosis of small renal masses, and differential diagnosis of different types of small renal masses by CEUS. Methods In 95 cases of small renal masses, there were 79 patients with small renal cell carcinoma and 16 patients with benign tumor. The diagnostic results of the three methods were compared based on the pathological results, which were used as thegold standardfor the diagnostic efficacy. The ROC curve was drawn, and the area under the curve (AUC) was compared. The characteristics of the two groups were analyzed and compared by Q-Lab software in CEUS. The angiographic parameters included arrival time (AT), time to peak (TTP) and peak intensity (PI). CEUS patterns for several pathologic types of renal tumors with larger sample sizes were compared. The characteristic manifestations of small renal masses under CEUS were analyzed. Results The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of CEUS were 87.37%, 93.67%, 56.25%, 91.36%, 64.29%and 0.750, the values for CECT were 88.42%, 93.67%, 62.50%, 92.50%, 66.67%and 0.775, and the values for combined detection of two methods were 95.79%, 98.73%, 81.25%, 96.30%, 92.86%and 0.869 respectively. The sensitivities of the three methods were high, but the specificities were the same. The combined detection showed better diagnostic efficacy than that of single diagnostic method. The AT and TTP of CEUS were earlier in small renal carcinoma group than those of benign nephrotic group, and PI was higher than that of benign nephrotic group (P<0.05). There were significant differences in the contrasts ofcontrast enhancement methods between clear cell carcinoma, papillary cell carcinoma, chromophobe cell carcinoma, and angiomyolipoma (P<0.01). There was little difference in contrast enhancement between the other types of carcinoma. False envelope can be observed by CEUS.'Cystic area'of the detection rate was increased significantly by CEUS than that of conventional ultrasound. Conclusion Combined detection of CEUS and CECT can improve the diagnostic accuracy of small renal tumors. CEUS has great clinical value in the differential diagnosis of small renal masses, which is worthy of clinical promoting.
4.Diagnostic value of breast tumor in color Doppler ultrasonography comparing with molybdenum mammography
Shuping ZHANG ; Suzhen HAO ; Yanpeng ZOU ; Jie SHENG ; Suhua DENG
Chinese Journal of Primary Medicine and Pharmacy 2008;15(2):236-238
Objective To evaluate the diagnostic value of color Doppler ultrasonography(CDUS)and molybdenum mammography for breast tumor.Methods 86 breast diseases which were diagnosed by the surgery and pathology,were prospectively analysed,40 in mammary carcinoma,and 46 in mammary benign disease.All the patients were examined with CDUS,CDFI and molybdenum mammography.Diagnosis was made in every case compared using two methods(CDUS and molybdenum mammagraphy)with any using only one method.Results There is significant difference between mammary carcinoma and mammary benign disease in CDUS.The mammary carcinoma patients'blood stream signal is abundant. The diagnostic veracity of using both CDUS and molybdenum mammography for breast tumor is obvious higher than that of the any only one method.Conclusion Combined CDUS with molybdenum mammography which is the optimal methods of the mammary image examination,can improve the diagnostic veracity of breast tumor.
7.Risk factors of severe intrahepatic cholestasis during early period after liver transplantation
Sheng ZHANG ; Jie ZHOU ; Yongfa TAN ; Kai TAN ; Liyan CHEN
Chinese Journal of Digestive Surgery 2012;(6):533-537
Objective To investigate the risk factors of severe intrahepatic cholestasis during early period after liver transplantation.Methods The clinical data of 225 patients who received orthotopic liver transplantation at the Nanfang Hospital of Southern Medical University from August 2004 to February 2011 were retrospectively analyzed.All patients were divided into positive group (60 patients with intrahepatic cholestasis) and negative group (165 patients without intrahepatic cholestasis).Preoperative,intraoperative and postoperative factors of the 2 groups were compared via t test,chi-square test,Wilcoxon test or Logistic regression analysis.Results The proportion of patients with hepatic cirrhosis,hepatic encephalopathy integral,ascites integral,international normalized ratio,and the levels of prothrombin time (PT),total bilirubin (TBil),aspartate aminotransferase of the positive group before operation were significantly higher than those in the negative group (x2 =6.09,Z =2.22,2.60,2.46,2.84,4.81,3.42,P < 0.05),while the levels of albumin,Na +,K +,hemoglobin,platelet (PLT) of the positive group in the operation were significantly higher than those in the negative group (t =2.10,4.97,Z =2.49,t =3.51,Z =3.66,P < 0.05).The ratio of compatible blood type of the donors and recipients,ratio of fatty liver graft,cold ischemia time,relative warm ischemia time,intraoperative blood loss,intraoperative transfusion of red blood cells,PLT,and cryoprecipitate of the positive group after the operation were significantly higher than those in the negative group (x2 =4.29,13.11,Z =2.45,2.61,3.75,3.20,2.89,3.95,P <0.05).The incidences of acute rejection,hepatic artery embolism,pulmonary infection,bacteraemia,fungal infection and cytomegalovirus (CMV) infection were significantly higher than those in the negative group (x2 =9.87,4.91,8.21,6.29,3.92,9.26,P <0.05).The results of multivariate analysis revealed that preoperative level of TBil > 51.3 μmol/L,fatty of the liver graft,intraoperative transfusion of cryoprecipitate,postoperative acute rejection,hepatic artery embolism,postoperative pulmonary infection,bacteraemia,CMV infection were independent risk factors of severe inrahepatic cholestasis (OR =15.82,7.99,2.88,3.03,53.20,3.34,4.11,3.22,P < 0.05).The incidence of severe intrahepatic cholestasis was significantly lower in patients with higher level of PLT and longer PT (OR =0.33,0.25,P < 0.05).The mortality rates of the positive group and negative group at 6 months after the operation were 41.7% (25/60) and 19.4% (32/165),and the mortality rate of the positive group was significantly higher (x2 =11.54,P < 0.05).Conclusion Correction of poor clinical status before liver transplantation,reinforcement of infection control and anti-rejection may reduce the incidences of complications and decrease the associated early mortality.
8.Research progress of circulating tumor cells detection and its clinical application
Jie GAO ; Fachang YU ; Kai CUI ; Bo ZHANG ; Sheng LI
International Journal of Surgery 2013;(5):327-331
Cancer cell exfoliation,invasion and entry into circulation system is the early event with metastasis,which provide the possibility to formation of clinical metastase.Further research about the circulating cancer cells can help us to understand the mechanism of metastasis and offer the scientific proof against anti-metastasis.The detection of circulating tumor cells and clinical significance were reviewed.
9.Levonorgestrel-releasing intrauterine system for treatment of dysmenorrhea associated with adenomyosis
Jie SHENG ; Dan LU ; Jian-Ping ZHANG ; Gui-Fen CUI ;
Chinese Journal of Obstetrics and Gynecology 2001;0(07):-
Objective To evaluate the efficacy and safety of a levonorgestrel-releasing intrauterine system(LNG-IUS)for the treatment of dysmenorrhea associated with adenomyosis.Methods We recruited 48 women with moderate or severe dysmenorrhea associated with adenomyosis.All women were inserted of LNG-IUS into their uterine cavity from days 5-7 of their periods and maintained for 12 months.We compared the visual analogue scale(VAS)scores and verbal rating scale(VRS)scores of their dysmenorrhea and dyspareunia at baseline and 12 monthes follow-up.Results Forty-four women completed the study. There were significant differences between mean VAS and VRS scores changes of dysmenorrhea and dyspareunia at baseline and 12 monthes follow-up,those of dysmenorrhea dropping from 75?13 to 11?11 and 2.3?0.4 to 0.4?0.3,those of dyspareunia dropping from 54?19 to 4?4 and from 1.6?0.8 to 0.2?0.2 respectively.Overall 29 women(66%)were very satisfied or satisfied with the one-year treatment. Conclusion Insertion of LNG-IUS alleviates moderate or severe dysmenorrhea associated with adenomyosis remarkably.
10.The Handbook of Nosocomial Infections Management:Evaluation of the Use and Effect
Xiaolian LU ; Wei TANG ; Liang LI ; Sheng ZHANG ; Jie CHEN
Chinese Journal of Nosocomiology 2009;0(24):-
OBJECTIVE To promote the management of nosocomial infections continuous improvement in the clinical and medical technology department.METHODS According to the regulation of nosocomial infections management,a handbook of nosocomial infections management for clinical and medical technology department was designed,and the monitors of nosocomial infection could perform real time inspection and record according require of the handbook.The department of nosocomial infections management examined the monitoring work of clinical and medical technology department every month and summarized every year,and the results were internalized to the valuation of medical quality management.RESULTS After 3 years of the usage of the handbook,the capability of the monitor groups of nosocomial infection and the quality of the all monitoring items were significantly improved;the qualified rates were all above 96.30%.CONCLUSIONS The handbook of nosocomial infections management is useful to improve the quality of nosocomial infections management in the clinical and medical technology department.