Objective To observe the value of ultrasound,CT and the combination for evaluating thyroid cancer(TC)involved peripheral structures.Methods Totally 102 patients with advanced TC were enrolled,and the value of ultrasound and CT for evaluating TC involved peripheral structures were analyzed taken post resection pathology as gold standards.Results The ultrasonic detection rate of TC involved laryngeal recurrent nerve and strap muscle was 47.37％(18/38)and 72.73％(24/33),while the CT detection rate was 15.79％(6/38)and 39.39％(13/33),respectively,the formers were better than the latters(both P＜0.05).Ultrasound had high sensitivity(88.24％),specificity(97.06％),and accuracy(94.12％)for diagnosing TC involved trachea,also had fair sensitivity(72.73％,72.73％),high specificity(96.70％,97.10％)and accuracy(94.12％,89.22％)for diagnosing TC involved thyroid cartilage and strap muscle.CT had high sensitivity(90.91％),specificity(92.31％)and accuracy(92.16％)for diagnosing TC involved thyroid cartilage,while had fair sensitivity(50.00％—76.47％)and high specificity(82.35％—88.46％)for diagnosing TC involved trachea,esophagus and blood vessels.The sensitivity and accuracy of combination of ultrasound and CT for evaluating TC involved peripheral structures were both higher than of each single method alone.Conclusion Combination of ultrasound and CT was valuable for evaluating TC involved peripheral structures.

Objective To observe the value of ultrasound,CT and the combination for evaluating thyroid cancer(TC)involved peripheral structures.Methods Totally 102 patients with advanced TC were enrolled,and the value of ultrasound and CT for evaluating TC involved peripheral structures were analyzed taken post resection pathology as gold standards.Results The ultrasonic detection rate of TC involved laryngeal recurrent nerve and strap muscle was 47.37％(18/38)and 72.73％(24/33),while the CT detection rate was 15.79％(6/38)and 39.39％(13/33),respectively,the formers were better than the latters(both P＜0.05).Ultrasound had high sensitivity(88.24％),specificity(97.06％),and accuracy(94.12％)for diagnosing TC involved trachea,also had fair sensitivity(72.73％,72.73％),high specificity(96.70％,97.10％)and accuracy(94.12％,89.22％)for diagnosing TC involved thyroid cartilage and strap muscle.CT had high sensitivity(90.91％),specificity(92.31％)and accuracy(92.16％)for diagnosing TC involved thyroid cartilage,while had fair sensitivity(50.00％—76.47％)and high specificity(82.35％—88.46％)for diagnosing TC involved trachea,esophagus and blood vessels.The sensitivity and accuracy of combination of ultrasound and CT for evaluating TC involved peripheral structures were both higher than of each single method alone.Conclusion Combination of ultrasound and CT was valuable for evaluating TC involved peripheral structures.

Objective To study the feasibility and results of laparoscopic surgery for cholelithiasis in elderly patients over 80 years old.Methods A retrospective study was conducted on 53 patients over 80 years old who underwent laparoscopic surgery for cholelithiasis from January 2015 to April 2017.Results The operation was successfully carried out on 53 patients.The intraoperative blood loss was 5 ～ 300 ml.The operation time was (93.5 ±41.2) minutes and the postoperative hospital stay was (11.0 ± 3.7) days.Postperative complications included bile leakage (n =5),intra-abdominal infection (n =1),pulmonary infection (n =5),wound seroma (n =2).There were no perioperative deaths.Conclusion Laparoscopic surgery for cholelithiasis was safe and efficacious in elderly patients over 80 years old.

BACKGROUND/AIMS: The relationship between C-peptide levels and gastrointestinal (GI) symptoms in type 2 diabetic patients is not clear. The purpose of this study is to examine the association between fasting C-peptide and GI symptoms of gastroparesis in type 2 diabetic patients. METHODS: We recruited 333 type 2 diabetic patients into the present study. All patients filled out questionnaires of gastroparesis cardinal symptom index (GCSI) to evaluate GI symptoms. Hospital anxiety and depression scale were adopted to define anxiety and depression. Patients with GCSI scores ≥ 1.9 were regarded as having symptoms of gastroparesis. RESULTS: In our study, 71 (21.3%) type 2 diabetic patients had GCSI scores ≥ 1.9. In comparison to patients with scores < 1.9, those with scores ≥ 1.9 had significantly lower fasting c-peptide levels (1.49 ng/mL vs 1.94 ng/mL, P < 0.001), higher prevalence of depression (40.9% vs 18.3%, P < 0.001) and anxiety (28.2% vs 13.0%, P = 0.002). Multivariate logistic regression revealed that fasting C-peptide was still significantly associated with symptoms of gastroparesis (odds ratio, 0.67; 95% confidence intervals, 0.48–0.94; P = 0.021), even after adjustments for age, sex, body mass index, HbA1c, current smoking and drinking status, anxiety, and depression. Furthermore, linear regressions showed that fasting C-peptide was independently and negatively related to GCSI scores (standardized regression coefficient, −0.29; P < 0.001) in patients with at least one GI symptom. CONCLUSION: GI symptoms of diabetic gastroparesis affect approximately 20% of type 2 diabetes patients and are associated with lower fasting C-peptide levels independent of depression and anxiety status.
Anxiety ; Anxiety Disorders ; Body Mass Index ; C-Peptide* ; Depression ; Depressive Disorder ; Diabetes Mellitus ; Drinking ; Fasting* ; Gastroparesis* ; Humans ; Linear Models ; Logistic Models ; Prevalence ; Smoke ; Smoking

Science of cardiac electrophysiology (EP), a most complicated professional branch of car-diovascular medicine, is composed of theoretical knowledge of EP, anatomical knowledge, catheter manipu-lation skills, and antiarrhythmic drug therapy. Longer growth period is involved in clinical cardiac EP physicians due to abstract and complicated electrophysiology knowledge. Starting with simple operation and case to stimulate students' interest in learning, this study focuses on the four teaching modules such as the theory of electrophysiology, the knowledge of anatomy, the skill of the operation of the catheter and the use of antiarrhythmic drugs. It also guides and trains students' simplified habit of thinking and independent thinking and induction learning ability, which improves the cardiac electrophysiologic doctors' efficiency of clinical practice.

Objective To improve the quality of life in patients with early penile carcinoma (T1N0M0) after partial excision of penile. Methods The clinical data of 21 patients with early penile carcinoma who were treated with partial excision of penile combined with penile lengthening surgery were retrospectively analyzed. Results The patients were followed up for 8 months to 5 years. None of patients had recurrence, and there were no external urethral stenosis and postoperative infection. The length of penile at extension state before surgery was 7.6-11.7 (8.3 ± 1.8) cm, and after surgery was 6.3-10.5 (7.4 ± 1.4) cm. All the patients were able to urinate in a standing position, 11 cases had normal sexual function, and 6 cases could complete after drug and psychological guidance. Conclusions Partial excision of penile combined with penile lengthening surgery is an effective treatment in patients with early penile carcinoma. It can significantly improve the patients' quality of life, and is an effective and feasible treatment method.

[ABSTRACT]OBJECTIVETo evaluate the clinical value of ultrasound guided fine-needle aspiration (US-FNA) in the diagnosis of thyroid nodules with different size.METHODSThe clinical data of 122 thyroid nodules of 109 cases referred to FNAC for diagnosis were retrospectively reviewed. The final operating histological results of 122 nodules were considered gold standard. RESULTSNon-diagnostic FNAC results occurred in 17 nodules (13.9%). FNAC achieved a sensitivity of 78.6%, a specificity of 93.9%, a positive predictive value of 93.6%, a negative predictive value of 78.3%, and a total accuracy of 85.7%. There was no significant difference between the diameter of the nodule≤1 cm group and>1 cm group, except negative predictive value. The non-diagnostic results rate was no significant difference between groups of different nodule size, benign or malignant nodules, and different operators. CONCLUSIONFNAC is a sensitive, specific and accurate method for differential diagnosis of thyroid nodules.

Objective To study the feasibility and results of laparoscopic anatomical liver resection for hepatolithiasis.Methods A retrospective study was conducted based on the clinical data of 103 patients who underwent laparoscopic anatomical liver resection from June 2007 to July 2013.Results Total laparoscopic anatomical liver resection was successfully carried out in 97 patients.The mean operation time was 225.5 minutes,the blood loss was 50 ～ 1 000 ml and the mean postoperative hospital stay was 11.4 days.Postoperative complications included bile leakage (n =18),abdominal cavity infection (n =3),pulmonary infection (n =4),wound seroma (n =3),right hepatic duct injury (n =1).There was no perioperative death.Conclusion Laparoscopic anatomical liver resection for hepatolithiasis is a feasible,practical,and minimally invasive procedure.

ObjectiveTo explore an individualized abdominal scan protocol with a 64-slice CT scanner.MethodsFrom Sep.2010 to Nov.2010,one hundred consecutive patients,who underwent twice non-contrast-enhanced abdominal CT scans within 3 months,were enrolled in this study.For each patient,the tube current of 274 eff.mAs and 207 eff.mAs were applied respectively in the first and second abdominal scan.The imaging qualities of the two scans were evaluated retrospectively by 3 reviewers.All the individual variants,including height,weight,body mass index (BMI),the maximum transverse diameter,the anteroposterior diameter and the average maximum diameter of abdomen were recorded.A five-point scale was used for grading the image noise of eight organs,including abdominal aorta,portal vein,liver,spleen,gallbladder,pancreas,renal cortex and renal medulla. Diagnostic acceptability of CT images at three anatomic levels,including porta bepatis,pancreas and the upper pole of renal,was also evaluated by using a five-point scale.The noise value of abdominal aorta was defined as the standard deviation (SD) of CT values of aorta at the level of porta hepatis.Scatter diagram and Pearson correlation analysis were used for evaluating the linear relationship between the individual variants and the noise value of abdominal aorta,and multivariate linear regression analysis was used for evaluating the relevance between the individual variants and the noise value of aorta.ResultsIn this patients group,the average height was ( 164.6 ± 7.5 ) cm,the average weight was (64.3 ± 11.0) kg,the BMI was (23.7 ±3.3) kg/m2,the maximum transverse diameter of abdomen was(29.8 ± 2.3 )cm,the anteroposterior diameter of abdomen was (23.1 ± 2.9) cm,and the average maximum diameter of abdomen was ( 26.5 ± 2.5 ) cm.Pearson correlation analysis showed significant positive linear correlation between the noise value of abdominal aorta( 1 1.7 ± 3.0)and patients' weight ( r =0.744,P ＜ 0.01 ),BMI ( r =0.689,P ＜ 0.01 ),the maximum transverse diameter ( r =0.813,P ＜ 0.01 ),the anteroposterior diameter ( r =0.781,P ＜ 0.01 ),the average maximum diameter of the abdomen ( r =0.789,P ＜ 0.01 ) ; however,there was no positive linear correlation between the noise value of abdominal aorta and patients' height ( r =0.292,P ＜ 0.01 ). The maximum transverse diameter of abdomen is greatly related to the noise value of abdominal aorta (Beta =0.487,P ＜0.01 ).For the patient with the maximum transverse diameter of abdomen ranging from 27 to 32 cm,diagnostic acceptability of CT images at the anatomic level of porta hepatis showed statistical significance compared with the patient with the maximal transverse diameter of the abdomen greater than 32 cm or less than 27 cm (P ＜ 0.05 ).Conclusion The tube current of 207 eft.mAs is reasonable for abdominal CT scan for patients with the maximal transverse diameter of the abdomen ranging from 27 to 32 cm.

Objective To evaluate the safety and feasibility of laparoscopic right hemi-hepatectomy for hepatolithiasis.Methods The clinical data of 3 patients who underwent laparoscopic right hemi-hepatectomy were analyzed retrospectively.Results In 2 patients the operation was performed successfully.The operative time was 340 min and 300 min,and the intraoperative blood loss was 800 ml and 400 ml.There was no need for blood transfusion.There was a small amount of bile leakage (30-60 ml/day) in these 2 patients.The postoperative hospital stay was 9 d and 11 d.The third patient was converted to open surgery because of profuse bleeding.All the 3 patients recovered well from surgery.Conclusions Total laparoscopic right hemi-hepatectomy for hepatolithiasis was safe and feasible.