Objective To assess the clinical value of conventional contrast enhanced CT(CECT),multi parameter energy spectrum CT,and contrast enhanced MR(CEMR)imaging methods in evaluating hepatocellular carcinoma(HCC)after TACE treatment.Methods The clinical data of 66 HCC patients,who underwent TACE treatment at authors' hospital and received CECT,multi parameter energy spectrum CT and CEMR in 1-3 months after treatment,were retrospectively analyzed.Taking DSA results as the gold standard,the recurrent or residual lesions detected by DSA were classified as positive lesions,while the lesions having no obvious recurrence or residues were classified as negative lesions.The positive lesions that were detected by both DSA and other imaging methods were regarded as true positive lesions.The accuracy,sensitivity,specificity,Kappa value were used to compare the values of CECT,multi parameter energy spectrum CT and CEMR in evaluating the positive/negative lesions of HCC after TACE treatment,and the number of detected lesions and accuracy rate were used to evaluate the values of the above imaging methods in demonstrating the iodine oil deposition status and in diagnosing true positive lesions.Results A total of 133 positive lesions and 35 negative lesions were detected by DSA.The accuracy of CEMR in diagnosing lesions was highest,the accuracy rate was 88.70％(both P＜0.05);CEMR and energy spectrum CT had the highest diagnostic efficiency,the sensitivity for positive lesions was 92.31％and 81.95％respectively,and the difference between the two methods was not statistically significant(P＞0.05).No statistically significant difference in the ability of diagnosing negative lesions existed between each other among the three groups(all P＞0.05).The Kappa value suggested that the ability for diagnosing lesions after TACE treatment of CEMR was stronger than that of energy spectrum CT(Kappa value was 0.68 and 0.56 respectively,both P＜0.05).CECT and multi parameter energy spectrum CT had the same accuracy in evaluating the iodine oil deposition status(both were 91.7％).No statistically significant difference in diagnosing even iodine oil deposition of the true positive lesions existed between each other among the three groups(all P＞0.05).For diagnosing uneven iodine oil deposition of the true positive lesions,CEMR had the highest accuracy(92.50％,all P＜0.05).Conclusion CEMR and multi parameter energy spectrum CT have more reliable diagnostic performance than conventional CECT,besides,CEMR has the highest diagnostic performance.However,multi parameter energy spectrum CT and CECT are the better choice for evaluating the deposition status of iodine oil.

Objective To compare the clinical value of microcoil and wired metal anchor hook in the preoperative localization of pulmonary nodules before video-assisted thoracoscopic surgery(VATS).Methods The clinical data of 84 patients with pulmonary nodules(90 lesions in total),who received preoperative localization of pulmonary nodules before VATS at the Hefei Municipal Third People's Hospital of China from July 2022 to May 2023,were retrospectively analyzed.Of the 84 patients,44 received microcoil localization method(microcoil localization group)and 40 received wired metal anchor hook localization method(wired metal anchor hook group).The success rate of pulmonary nodule localization,the time spent for localization,the complications,the number of CT scans,and the pathological results were compared between the two groups.Results In the microcoil localization group and wired metal anchor hook localization group,the success rate of pulmonary nodule localization was 95.92％(47/49)and 97.56％(40/41)respectively,the difference between the two groups was not statistically significant(P=0.875).The overall incidence of complications in the microcoil localization group was 20.46％,which was remarkably higher than 5.00％in the wired metal anchor hook localization group(P=0.036),the time spent for localization in the microcoil localization group was(19.85±0.86)min,which was obviously longer than(15.69±1.39)min in the wired metal anchor hook localization group(P＜0.01).The numbers of puncturing times and CT scans in the microcoil localization group were larger than those in the wired metal anchor hook localization group(both P＜0.05).No statistically significant differences in the incidences of pneumothorax,bleeding and cough,the depth distance between the localization needle and the pleura,and the postoperative pathological results existed between the two groups(all P＞0.05).Conclusion Compared with microcoil localization method,wired metal anchor localization method carries lower incidence of complications and is easy to operate,therefore,it is worthy of clinical promotion.

Objective To compare the effects of different doses of propofol on cardiac pump function in morbidly obese patients. Methods Forty morbidly obese patients undergoing laparoscopic Roux-en-Y gastric by-pass were randomly divided into lean body weight(LBW)group and total body weight(TBW)group,with 20 cases in each group.In LBW group,patients were induced by propofol with a dose according to LBW(kg)×2.0 mg/kg but in TBW group,patients were induced by propofol depending on TBW of the patients.We monitored the changes of left ventricular ejection fraction(LVEF)and stroke volume(SV)in patients before anesthetic induction(T1)and at 1 min(T2)after propofol administration.At the same time,we monitored invasive arterial pressure,noninvasive arterial pressure,BIS,and SpO2.Results Compared with those measured at T1,LVEF and SV were decreased af-ter the induction of anesthesia in the 2 groups(P < 0.05);compared with LBW,TBW had greater influence on LVEF and SV after the induction of anesthesia(P<0.05);compared with those at T1,non invasive arterial blood pressure,invasive arterial blood pressure and mean arterial pressure decreased after theinduction of anesthesia (P<0.05);compared with LBW,TBW had no significant effect on noninvasive arterial blood pressure,invasive arterial blood pressure and mean arterial pressure after the induction of anesthesia(P < 0.05);BIS was less than 50 after the induction of anesthesia in 2 groups. Conclusion Propofol induction with a LBW-dependent dose has less influence on cardiac pump function in morbidly obese patients while ensuring the depth of anesthesia.

OBJECTIVE: The purpose of this study is to explore the effect of reconstruction for the nose cranial base defects after removal of tumor with ADM. METHOD: Thirteen patients with the nose skull base defects after tumors resection underwent cranial base reconstruction with ADM at the same time. Postoperatively, routine endoscopic and CT scan were performed on all patients at regular intervals. RESULT: The successful cranial base reconstruction was achieved in 13 patients with ADM. Intracranial infection occurred in 3 patients and recovered after two weeks postoperatively, given combination of antibiotics, dexamethasone anti-inflammatory, mannitol, reduce intracranial pressure with diuretics and cooling, sedation processing. All patients developed no delayed complications. CONCLUSION Our experience has demonstrated that the cranial base reconstruction with the ADM "I" shaped sandwich has harvest the satisfactory effect.
Acellular Dermis ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Skull Base ; surgery ; Transplantation, Homologous ; Young Adult