Objective To observe the value of high-resolution vascular wall imaging(HR-VWI)for differentiating perforating branch subtype and other subtype basilar artery(BA)ischemic stroke.Methods Totally 147 patients with posterior circulation ischemic stroke were retrospectively enrolled and divided into perforating branch group(perforating branch BA atherosclerosis,n=57)and multi-mechanism group(artery-to-artery embolism and/or hypoperfusion,n=90)according to MRI findings and Chinese ischemic stroke subclassification(CISS).Clinical data,HR-VWI and MR angiography parameters were compared between groups,and those being significantly different were included in logistic regression analysis to construct a model.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of the model for differentiating perforating branch subtype and other subtype BA ischemic stroke.Results The proportion of diabetes mellitus(DM)and dorsal plaque were both higher,while proportion of ventral plaque in perforating branch group was lower than those in multi-mechanism group(all P＜0.05).No significant difference of the other clinical data,nor of the maximum wall thickness,lumen eccentricity index,lumen area,wall area,vascular stenosis rate,plaque load,vascular remodeling index and BA course of culprit plaques section was found between groups(all P＞0.05).DM and dorsal plaque were both independent risk factors for perforating BA atherosclerosis,whereas ventral plaque was the independent protective factor(all P＜0.05).The sensitivity,specificity and AUC of the model for differentiating perforating branch subtype and other subtypes of BA ischemic stroke was 82.46％,70.00％and 0.839,respectively.Conclusion HR-VWI could be used to differentiating perforating branch subtype and other subtype BA ischemic stroke.

Objective To observe the value of high-resolution vascular wall imaging(HR-VWI)for differentiating perforating branch subtype and other subtype basilar artery(BA)ischemic stroke.Methods Totally 147 patients with posterior circulation ischemic stroke were retrospectively enrolled and divided into perforating branch group(perforating branch BA atherosclerosis,n=57)and multi-mechanism group(artery-to-artery embolism and/or hypoperfusion,n=90)according to MRI findings and Chinese ischemic stroke subclassification(CISS).Clinical data,HR-VWI and MR angiography parameters were compared between groups,and those being significantly different were included in logistic regression analysis to construct a model.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of the model for differentiating perforating branch subtype and other subtype BA ischemic stroke.Results The proportion of diabetes mellitus(DM)and dorsal plaque were both higher,while proportion of ventral plaque in perforating branch group was lower than those in multi-mechanism group(all P＜0.05).No significant difference of the other clinical data,nor of the maximum wall thickness,lumen eccentricity index,lumen area,wall area,vascular stenosis rate,plaque load,vascular remodeling index and BA course of culprit plaques section was found between groups(all P＞0.05).DM and dorsal plaque were both independent risk factors for perforating BA atherosclerosis,whereas ventral plaque was the independent protective factor(all P＜0.05).The sensitivity,specificity and AUC of the model for differentiating perforating branch subtype and other subtypes of BA ischemic stroke was 82.46％,70.00％and 0.839,respectively.Conclusion HR-VWI could be used to differentiating perforating branch subtype and other subtype BA ischemic stroke.

Objective: To evaluate and compare the surgery prognosis of the papillary thyroid carcinoma (PTC) patients who underwent conventional and endoscopic thyroidectomies via areola. Methods: From January 2012 to December 2017, 887 patients with PTC underwent thyroidectomy. The A group of 693 patients underwent traditional thyroidectomy, and B group of 194 patients underwent endoscopic thyroidectomy. Clinicopathologic characteristics, surgical methods, pathological features and complications were analyzed and compared between two groups. Results: The mean age of A group was older than B group: (45.2 ± 11.5) years vs. (34.9 ± 9.4) years, P<0.01. The drainamount and drain maintenance in B group were significantly higher than those in A group (P<0.01). The operative methods in two group had significant difference (P<0.01). The patients in B group were successful in operation and no one transferred to open operation. The tumor size in the A group was larger than that in B group, and more bilateral multifocal tumors were in A group (P<0.01). The number of lymph nodes dissection in A group was more than that in B group (P<0.01). There was no significant difference in the postoperative complications (P > 0.05). Conclusions The results show that patients with PTC who underwent conventional and endoscopic thyroidectomies via areola have similar surgical prognosis.Therefore, choosing the appropriate cases for endoscopic thyroidectomy via breast areola approach may be regarded as an alternative surgical technique to conventional thyroidectomy which has the oncological safety and cosmetic results.

Objective To explore the value and method of using carbon nanoparticles in endoscopic treatment of papillary thyroid microcarcinoma.Method 74 cases were randomly divided into two groups,34 cases in experimental group which were injected with carbon nanoparticles,and 40 cases in the control group without any injection.All cases were analyzed in terms of the tumor size,the number of lymph nodes and parathyroid gland injury.Results All patients underwent the operation smoothly.The postoperative pathological specimens result showed there was no statistical difference of carcinoma size between the two groups.The number of lymph nodes dissected was 177 in the control group and 220 in the experimental group (the rate of lymph node black staining rate was 89％).In the experimental group,the average number of lymph node detected in each patient was 6.47±2.13,more than 4.42±1.91 in the control group.The number of parathyroid glands found in the experimental group was 3 and 11 in the control group,and the difference had no statistical significance.Postoperative temporary laryngeal recurrent nerve injury occurred to 2 cases in each group,and no statistical difference was found.Conclusion Using carbon nanoparticles in endoscopic treatment of papillary thyroid microcarcinoma can increase the detection rate of lymph node,and to some extent,reduce the parathyroid injury.It has a certain clinical significance,However,care should be taken to avoid contamination of the mirror field of view.