As an important method to detect intracranial arterial stenosis or occlusive disease,transcranial Doppler(TCD)has been widely used in clinical practice because of its low price and easy operation.The scope of application of TCD includes,but is not limited to,the diagnosis and collateral evaluation of intracranial artery stenosis or occlusive disease,intraoperative monitoring of carotid endarterectomy,assessment of brain death,etc.,but the characteristics of TCD blood flow changes of some special structures of intracranial arteries need to be improved.This paper presented 3 cases with special intracranial artery structures,and comprehensively analyzes the blood flow spectrum on TCD based on medical images,in order to improve clinicians'exploration experience on similar cases and the level of cerebrovascular ultrasound.

Background and purpose:In 2016 the National Cancer Institute(NCI)decided stopping to use NCI-60 cell lines for drug screening,suggesting that tumor cell lines were losing their value as a tool for drug discovery and basic research.The reason for NCI-60 cells'retirement'was that the preclinical studies based on traditional cellular and animal models did not obtain the corresponding expected efficacy in clinical trials.Since the major cancer behaviors,such as proliferation and metastasis,are fundamentally altered with long-term culture,the tumor cell lines are not representative of the characteristics of cancer in patients.Currently,scientists hope to create a new cancer model that are derived from fresh patient samples and tagged with details about their clinical past.Our purpose was to create patient-derived breast cancer primary cell lines as new cancer model for drug screening and basic research.Methods:Breast cancer tissues were collected in the Department of Breast Surgery,Affiliated Hospital of Guizhou Medical University.The collection of tumor tissue samples was approved by the Ethics Committee of the Affiliated Hospital of Guizhou Medical University(approval number:2022 ethics No.313),and the collection and use of tumor tissues complied with the Declaration of Helsinki.The primary breast cancer cell lines were isolated from the patient's breast cancer tissues and cultured in BCMI medium.After the cells proliferated,the media were replaced with DEME medium.Cell line STR genotyping was done to determine cell-specific genetic markers and identification.Clone formation assay and transplantation assay were done to analyze the ability of breast cancer primary cell lines to form tumors.Results:We created 6 primary breast cancer cell lines.The 6 primary breast cancer cell lines from the patients were tagged with the definitively clinicopathological features,clinical diagnosis,therapeutic regimens,clinical effectiveness and prognostic outcomes.The STR genotyping assays identified the genetic markers and determined the identities of the 6 primary breast cancer cell lines.Clone formation assays and transplantation assay showed that the proliferative capacities of the patient-derived primary breast cancer cell lines were significantly greater compared with the conventional breast cancer cell lines.Conclusion:We created a panel of 6 patient-derived primary breast cancer cell lines as new cancer model for drug screening and basic research in breast cancer.

Objective:To propose a method of cervical cytology screening based on deep convolutional neural network and compare it with the diagnosis of cytologists.Method:The deep segmentation network was used to extract 618 333 regions of interest (ROI) from 5, 516 cytological pathological images. Combined with the experience of physicians, the deep classification network with the ability to analyze ROI was trained. The classification results were used to construct features, and the decision model was used to complete the classification of cytopathological images.Results:The sensitivity and specificity were 89.72%, 58.48%, 33.95% and 95.94% respectively. Among the smears derived from four different preparation methods, this algorithm had the best effect on natural fallout with a sensitivity of 91.10%, specificity of 69.32%, positive predictive rate of 41.41%, and negative predictive rate of 97.03%.Conclusion:Deep convolutional neural network image recognition technology can be applied to cervical cytology screening.

OBJECTIVE： To investigate the effects of Kangfuxin liquid on repairing cartilage defect model of knee osteoarthritis （KOA） in rabbits and its mechanism. METHODS： Totally 72 male New Zealand rabbits were selected and randomly divided into model control group and Kangfuxin low-dose， medium-dose， high-dose groups， with 18 rabbits in each group. A cartilage defect model of the medial femoral condyle of the right knee joint in rabbits was established by drilling after anesthesia surgery. Then the rabbits in each group were given medicine via articular cavity immediately. Kangfuxin low-dose， middle-dose and high-dose groups were given 20％， 40％， 80％ Kangfuxin liquid； model control group was given constant volume of normal saline consecutively， 0.2 mL/kg， once every 3 days. At 4th， 8th， 12th week after medication， the wound repair of cartilage defect in rabbits was observed. Immediately after medication and at 4th， 8th， 12th week after medication， repaired tissue of cartilage defect in rabbits was scored histologically with Wakitani scoring standard under light microscope. At 12th week after medication， pathological changes of repaired tissue of cartilage defect in rabbits were observed by Masson staining. The levels of NO， SOD and LPO in joint fluid and PYD in urine of rabbits were detected by ELISA. RESULTS： At 4th， 8th， 12th week after medication， compared with model control group， cartilage defects in rabbits were repaired well in Kangfuxin low-dose， medium-dose and high-dose groups. At 4th， 8th， 12th week after medication， compared with immediately after medication and model control group at same time point， histomorphological score of repairing cartilage defect of knee joint in rabbits decreased significantly in Kangfuxin low-dose， medium-dose and high-dose groups （P＜0.05）. At 12th week after medication， compared with model control group， the histopathology degree of cartilage defect of knee joint in rabbits was significantly alleviated in Kangfuxin low-dose， medium-dose and high-dose groups. At 4th， 8th， 12th week after medication， compared with model control group， the levels of NO and LPO in joint fluid and PYD level in urine were decreased to different extent in Kangfuxin low-dose， medium-dose and high-dose groups， while SOD level was increased to different extent； at 12th week after medication， the difference of each index has statistical significance （P＜0.05 or P＜0.01）. CONCLUSIONS： Kangangxin liquid can significantly repair cartilage defect of KOA cartilage defect model rabbits， the mechanism of which may be associated with increasing the expression of SOD and mediating NO-inhibited chondrocyte apoptosis.

Objective: To evaluate the feasibility and outcomes of the reconstruction of large anterior palatal fistulae by anteriorly based dorsal tongue flaps to provide a rational reference of anteriorly based dorsal tongue flaps for clinicians. Methods : Five patients with anterior hernia had a defect range of 1.0 cm × 1.0 cm to 1.5 cm × 2.0 cm, and the anterior tongue was 1.3 cm × 3.5 cm to 2.0 cm × 3.5 cm. The defects were all repaired with anteriorly based dorsal tongue flaps. The clinical efficacy was evaluated after operation, including whether the mucosal flap was infected, whether there was any shedding before the pedicle, and whether there was any perforation after operation. Thereafter, patients who were satisfied with their chewing, swallowing, speech function and appearance were followed up Results: All patients underwent successful reconstruction of palatal defects by anteriorly based tongue flaps, and no case of spontaneous detachment of the tongue flap occurred. Patients with palatal fistulae were followed up for 16-28 months, and no recurrence was encountered. The operation had no effect on the speech, agitation and swallowing function of the tongue, and patients were satisfied with the appearance. Conclusion The dorsal lingual mucosal flap pedicled with the anterior tongue is a safe and reliable method for repairing large anterior palatal fistula.

Objective To explore the application of diffusion tensor imaging (DTI)in crossed cerebellar diaschisis (CCD)of cerebral gliomas. Methods MR images of 17 patients with high grade gliomas and 20 patients with low grade gliomas confirmed by postoperative pathology and 18 normal controls were analyzed retrospectively.The fractional anisotropy (FA)of cerebellar hemisphere was quantitatively measured with DTI technique.The asymmetry index (AI)of cerebellar hemispheric was calculated and compared in patients.The correlation between CCD phenomenon and histological grade of cerebral gliomas was also analyzed.Results Compared with ipsilateral cerebellar hemisphere of cerebral high grade gliomas,the FA value of contralateral cerebellar hemisphere significantly reduced (t=3.42,P<0.05).But there were no significant differences of FA values between contralateral cerebellar hemisphere and ipsilateral cerebellar hemisphere in cerebral low grade gliomas patients (t=0.80,P>0.05).The AI values of cerebellar hemisphere in high grade gliomas increased compared with low grade gliomas and normal controls (t=4.15,P<0.05;t=4.68,P<0.05),but there were no significant differences in the AI values of cerebellar hemisphere between low grade gliomas patients and normal controls (t=0.79,P>0.05).Conclusion CCD phenomenon is associated with the histological grade of cerebral gliomas.High grade gliomas can cause CCD phenomenon,but there is no evident CCD phenomenon in low grade gliomas.DTI technique is able to quantitatively assess CCD noninvasively by FA parameter.

OBJECTIVETo investigate the surgical and oncological outcomes after laparoscopic pancreaticoduodenectomy (LPD), and compare its efficacy with open pancreaticoduodenectomy (OPD).

METHODSClinical data of 40 patients with malignant tumor undergoing pancreaticoduodenectomy between January 2012 and January 2013 in our department were retrospectively analyzed. Patients were divided into LPD and OPD group according to operative procedure. Operative time, blood loss, harvested lymph nodes, drainage on first postoperative day (POD1), first flatus day, time to liquid diet, postoperative period of fever, postoperative hospital stay, postoperative complications, and 1-year cumulative survival rate and recurrence rate were compared between the two groups.

RESULTSThere were no significant differences between the two groups in operative time, harvested lymph nodes, TNM stages, postoperative period of fever, time to drain removal, postoperative complications, 1-year cumulative survival rate and recurrence rate (all P>0.05). As compared to OPD group, LPD group showed less blood loss [(168.2±87.4) ml vs.(353.5±140.1) ml, P<0.001], drainage on POD1 [(157.7±69.7) ml vs. (289.1±197.0) ml, P=0.039], earlier flatus [(4.1±0.9) d vs. (6.6±3.4) d, P=0.024], shorter time to liquid diet [(5.8±1.3) d vs. (8.2±3.5) d, P=0.040], earlier ambulation [(3.6±1.4) d vs.(6.2±1.5) d, P<0.001], and shorter postoperative hospital stay [(17.0±2.2) d vs.(25.7±13.8) d, P=0.047].

CONCLUSIONLPD confers similar surgical and oncological outcomes and is superior to OPD in terms of decreased blood loss and rapid postoperative recovery.

Aged ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; Laparotomy ; Male ; Middle Aged ; Pancreaticoduodenectomy ; methods ; Retrospective Studies

OBJECTIVETo further understand the anatomical basis of pelvic autonomic nerve preservation.

METHODSAutopsy of five adult male donated cadavers was performed. Meanwhile, ten videos of laparoscopic total mesorectal excision for male mid-low rectal cancer admitted from January to June 2012 were observed and studied. Anatomical features of pelvic autonomic nerve were compared between autopsy and laparoscopic appearance.

RESULTSAutopsy observations indicated that:the abdominal aortic plexus was situated upon the sides and front of the aorta, between the origins of the superior and inferior mesenteric arteries. The superior hypogastric plexus was a plexus of nerves situated on the the bifurcation of the abdominal aorta to sacrum; after incision of sacrum fascia was done cling to the sacrum; the pelvic splanchnic nerves and sacral splanchnic nerves were demonstrated; pelvic splanchnic nerves were splanchnic nerves that arised from ventral rami of the second, third, and often the fourth sacral nerves to provide preganglionic parasympathetic innervation to the hindgut;sacral splanchnic nerves providing postganglionic fibers, emerged from the sympathetic trunk, were then joined by the pelvic splanchnic nerves to form the inferior hypogastric plexuses which were placed lateral to the rectum.Laparoscopic observations showed that:abdominal aortic plexus and superior hypogastric plexus were unclear; at the level of sacroiliac joint, the hypogastric nerve began where the superior hypogastric plexus split into a right and left plexus, situated under the loose connective tissue, and continued inferiorly on its corresponding side of the body at the level of the 3rd sacral vertebra;left hypogastric nerve was closed to posterior of mesorectum;denonvilliers fascia was thin, reflective fascial structure, and easily removed together with mesorectum excision because of anterior loose structure.

CONCLUSIONSLigation of the inferior mesenteric artery at its origin is safe.Excessive dissection of the connective tissue covering the surface of the aorta should be avoided to protect the abdominal aortic plexus.Sharp dissection performed by pursuing the outer surface of the mesorectum maintaining the integrity of mesorectum, could avoid the superior hypogastric plexus and hypogastric nerves injury posteriorly, and protect the inferior hypogastric plexues while cutting lateral ligament laterally. The integrity of Denonvilliers fascia during anterior resection of rectum should be confirmed to avoid urogenitalis aparatus branches damage.

Adult ; Autonomic Nervous System ; anatomy & histology ; Autopsy ; Humans ; Laparoscopy ; Male ; Pelvis ; innervation ; Rectal Neoplasms ; surgery

Objective To investigate the surgical and oncological outcomes after laparoscopic pancreaticoduodenectomy (LPD), and compare its efficacy with open pancreaticoduodenectomy (OPD). Methods Clinical data of 40 patients with malignant tumor undergoing pancreaticoduodenectomy between January 2012 and January 2013 in our department were retrospectively analyzed. Patients were divided into LPD and OPD group according to operative procedure. Operative time, blood loss, harvested lymph nodes, drainage on first postoperative day (POD1), first flatus day, time to liquid diet, postoperative period of fever, postoperative hospital stay, postoperative complications, and 1-year cumulative survival rate and recurrence rate were compared between the two groups. Results There were no significant differences between the two groups in operative time, harvested lymph nodes, TNM stages, postoperative period of fever, time to drain removal, postoperative complications, 1-year cumulative survival rate and recurrence rate (all P>0.05). As compared to OPD group, LPD group showed less blood loss [(168.2 ±87.4) ml vs. (353.5 ±140.1) ml, P<0.001], drainage on POD1 [(157.7±69.7) ml vs. (289.1±197.0) ml, P=0.039], earlier flatus [(4.1±0.9) d vs. (6.6±3.4) d, P=0.024], shorter time to liquid diet [(5.8 ±1.3) d vs. (8.2 ±3.5) d, P=0.040], earlier ambulation [(3.6±1.4) d vs.(6.2±1.5) d, P<0.001], and shorter postoperative hospital stay [(17.0±2.2) d vs. (25.7±13.8) d, P=0.047]. Conclusion LPD confers similar surgical and oncological outcomes and is superior to OPD in terms of decreased blood loss and rapid postoperative recovery.

Objective To investigate the surgical and oncological outcomes after laparoscopic pancreaticoduodenectomy (LPD), and compare its efficacy with open pancreaticoduodenectomy (OPD). Methods Clinical data of 40 patients with malignant tumor undergoing pancreaticoduodenectomy between January 2012 and January 2013 in our department were retrospectively analyzed. Patients were divided into LPD and OPD group according to operative procedure. Operative time, blood loss, harvested lymph nodes, drainage on first postoperative day (POD1), first flatus day, time to liquid diet, postoperative period of fever, postoperative hospital stay, postoperative complications, and 1-year cumulative survival rate and recurrence rate were compared between the two groups. Results There were no significant differences between the two groups in operative time, harvested lymph nodes, TNM stages, postoperative period of fever, time to drain removal, postoperative complications, 1-year cumulative survival rate and recurrence rate (all P>0.05). As compared to OPD group, LPD group showed less blood loss [(168.2 ±87.4) ml vs. (353.5 ±140.1) ml, P<0.001], drainage on POD1 [(157.7±69.7) ml vs. (289.1±197.0) ml, P=0.039], earlier flatus [(4.1±0.9) d vs. (6.6±3.4) d, P=0.024], shorter time to liquid diet [(5.8 ±1.3) d vs. (8.2 ±3.5) d, P=0.040], earlier ambulation [(3.6±1.4) d vs.(6.2±1.5) d, P<0.001], and shorter postoperative hospital stay [(17.0±2.2) d vs. (25.7±13.8) d, P=0.047]. Conclusion LPD confers similar surgical and oncological outcomes and is superior to OPD in terms of decreased blood loss and rapid postoperative recovery.