Objective To observe early changes of left atrial strain and left atrial stiffness index(LASI)in rabbits with left ventricular myocardial injury induced by adriamycin(ADM).Methods Eighteen New Zealand white rabbits were randomly divided into experimental group(n=12)and control group(n=6),while 2 mg/kg ADM was injected into rabbits in experimental group and 5 ml physiological saline was injected into rabbits in control group every week for a total of 4 weeks.Ultrasound examination was performed before injection of ADM/physiological saline,2 and 4 weeks after injection,respectively.Left atrial anteroposterior diameter(LAAPD),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),lateral wall of mitral ring of early peak flow velocity(e),mitral valve orifice early peak flow velocity(E)/e,left ventricular global longitudinal strain(LVGLS),right ventricular collectivity long axis strain(RVCLS),left atrial strain during reservoir phase(LASr),left atrial strain during conduit phase(LAScd),left atrial strain during contraction phase(LASct)and LASI were obtained and analyzed.After ultrasound examination,myocardial changes were observed with pathological examination.Results Four weeks after injection,e in experimental group was significantly lower than that before injection,also lower than that 2 and 4 weeks after injection in control group(all P＜0.05).Significant differences of LASr,LAScd,LASct and LASI were found among different time points between groups(all P＜0.05).Two and 4 weeks after injection,the above 4 parameters in experimental group were all significantly different with those in control group(all P＜0.05).LASr,LASct and LASI were different among different time points,while LAScd before injection was higher than that 2 and 4 weeks after injection in experimental group(all P＜0.05).The pathological findings supported ultrasonic changes.Conclusion In early stage of ADM induced left ventricular myocardial injury in rabbits,changes of left atrial strain and LASI could be seen,which were more significant than those of LVGLS,RVCLS and LVEF,etc.

Objective To observe early changes of left atrial strain and left atrial stiffness index(LASI)in rabbits with left ventricular myocardial injury induced by adriamycin(ADM).Methods Eighteen New Zealand white rabbits were randomly divided into experimental group(n=12)and control group(n=6),while 2 mg/kg ADM was injected into rabbits in experimental group and 5 ml physiological saline was injected into rabbits in control group every week for a total of 4 weeks.Ultrasound examination was performed before injection of ADM/physiological saline,2 and 4 weeks after injection,respectively.Left atrial anteroposterior diameter(LAAPD),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),lateral wall of mitral ring of early peak flow velocity(e),mitral valve orifice early peak flow velocity(E)/e,left ventricular global longitudinal strain(LVGLS),right ventricular collectivity long axis strain(RVCLS),left atrial strain during reservoir phase(LASr),left atrial strain during conduit phase(LAScd),left atrial strain during contraction phase(LASct)and LASI were obtained and analyzed.After ultrasound examination,myocardial changes were observed with pathological examination.Results Four weeks after injection,e in experimental group was significantly lower than that before injection,also lower than that 2 and 4 weeks after injection in control group(all P＜0.05).Significant differences of LASr,LAScd,LASct and LASI were found among different time points between groups(all P＜0.05).Two and 4 weeks after injection,the above 4 parameters in experimental group were all significantly different with those in control group(all P＜0.05).LASr,LASct and LASI were different among different time points,while LAScd before injection was higher than that 2 and 4 weeks after injection in experimental group(all P＜0.05).The pathological findings supported ultrasonic changes.Conclusion In early stage of ADM induced left ventricular myocardial injury in rabbits,changes of left atrial strain and LASI could be seen,which were more significant than those of LVGLS,RVCLS and LVEF,etc.

[Summary] Thyroid nodules are the most common endocrine and metabolic diseases,and most of them are accidental nodules.How to distinguish the state between benign and malignant thyroid nodules is the clinical core problems in diagnosis and treatment.In addition to detailed history collecting and physical examination,highresolution ultrasound,serum thyrotrophin levels,and fine needle aspiration biopsy (FNAB) form the basis for the diagnosis of thyroid nodules.Endocrinologists should grasp the indications of FNAB.When the pathological finding is unable to distinguish between benign and malignant nodules,molecular or genetic diagnosis should be adopted for further diagnosis.Appropriate treatment is selected according to the definitive results.In this article,we share the whole process that one case with thyroid nodule was diagnosed as papillary thyroid carcinoma and eventually treated with surgery,so as to make clinicians pay more attention to thyroid nodules with standardized clinical diagnosis and treatment.

OBJECTIVETo explore the CT features of ground-glass nodules (GGN) including preinvasive lesions [atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS)], minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC).

METHODSNinety-seven GGN lesions confirmed by operation pathology were included in this study. The lesions were divided into three groups: preinvasive lesion group (24 cases), MIA group (39 cases), IAC group (34 cases). The lesion size, 3-dimensional ratio, 2-dimensional ratio in axial images, lesion density, shape, speculation, lobulation, air-containing space and pleural indentation on the preoperative CT images in the three groups were analyzed and compared with pathological results. The data were statistically analyzed using SPSS 17.0.

RESULTSAll preinvasive lesions presented as pure GGN on CT image, most showed round-like shape, clear and smooth border. MIA presented as pure GGN or mixed GGN on CT image, most showed round-like shape, with a clear and smooth border. IAC most presented as mixed GGN on CT image, often showed irregular shape. Speculation, lobulation, air-containing space and pleural indentation displayed gradually increasing from preinvasive lesions to MIA and IAC. There were statistically significant differences in lesion size, CT density, shape, air-containing space, speculation, pleural indentation and long diameter of solid component between the MIA and IAC groups (P < 0.05 for all). There were statistically significant differences in CT density values and long diameters of solid component of the lesions between the preinvasive lesion group and MIA group (P < 0.05). The AUC of solid component of the preinvasive lesion group and MIA group was 0.705, and that of the MIA and IAC groups was 0.814.

CONCLUSIONComprehensive analysis of the CT image features of GGNs, especially the solid component in the lesions, may help to the preoperative and differential diagnosis of preinvasive lesions, MIA and IAC.

Adenocarcinoma ; diagnostic imaging ; pathology ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Hyperplasia ; Lung ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Precancerous Conditions ; diagnostic imaging ; pathology ; Solitary Pulmonary Nodule ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

OBJECTIVETo dicuss the application and therapeutic effect of middle-forearm flap based on perforator of ulnar artery for electrical burn wound on the wrist.

METHODSFrom Oct. 2009 to Oct. 2012, 10 cases of electrical burn wounds on the wrist were treated. A line from radialis medial epicondyle of humerus to the interior radialis pisiform bone was connected as flap axis. At the midpoint of the line, Doppler flow imaging meter was used to detect the emerging point of perforator vessel. The flap was designed and harvested. The flap was transferred reversely, with superficial vein retaining which was anastomosed with vein at recipient sites in 3 cases. The wounds in the donor sites were closed directly in 2 cases, and with skin graft in 8 cases.

RESULTSAll the 10 flaps survived completely. 7 cases without vein anastomosis underwent obvious flap edema during 2-4 days postoperatively, which resovled 1 week later. Sub-flap tissue necrosis and infection happened in 2 cases, which healed after dressing and drainage. Patients were followed up for 3-36 months with satisfactory results.

CONCLUSIONSThe middle-forearm flap based on perforator of ulnar artery has a stable and reliable blood supply. It offers a new choice for the electric burn wound on the wrist, especially at the ulnar side.

Burns, Electric ; surgery ; Forearm ; Humans ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; blood supply ; transplantation ; Ulnar Artery ; Wrist Injuries ; surgery