ObjectiveTo investigate the feasibility of lung tissue flap repairing esophagus defect with an inner chitosan tube stentin in order to complete repairing and reconsruction of the esophagus defect.MethodsFifteen Japanese white rabbits were randomly divided into two groups， experiment group(n=10): esophagus defect was repaired with lung tissue flap having inner chitosan tube stent; control group(n=5): esophagus defect was repaired with lung tissue flap without inner chitosan tube stent; and then the gross and histological apearance in both groups were observed at 2, 4,8 weeks after operation, barium sulphate X-ray screen were observed at 10 weeks after operation.ResultsSix rabbits survived for over two weeks in experiment group, lung tissue flap healed with esophageal defect, squamous metaplasia were found on the surface of lung tissue flap in experiment group. At 10 weeks after operation, barium sulphate examination found that barium was fluent through the esophageal and no narrow or reversed peristalsis, the peristalsis was good in experiment group.Four rabbits survived for two weeks and the lung tissue flap healed with esophageal defect, fibrous tissue hyperplasy on the surface of the lung tissue flap in control group. At 10 weeks after operation, barium sulphate examination found that barium was fluent through the esophageal and slight narrow or reversed peristalsis, the peristalsis was not good in control group, otherwise.ConclusionIt is a feasible method to repair the esophageal defect with lung tissue flap with the inner chitosan stent.
【Abstract】 Objective To review the recent progress of hi p resurfacing arthroplasty. Methods Literatureconcerning hip resurfacing arthroplasty and current achievements was extensively and comprehensively reviewed. Results The new metal-on-metal hip resurfacing arthroplasty made much progress especially in materials and technology, and the results were satisfactory for short-term follow-up. This was increasingly widely used especially in treating young patients. But there were still some problems such as elevation of metal ions which had already aroused publ ic attention. Conclusion The new metal-onmetal hip resurfacing arthroplasty is an efficient method in the treatment of adult hip joint disease and has an encouraging future, but long-term follow-up is still needed.
【摘要】 目的 研究使用Bowtie滤线器（F1）后，保证加速器CBCT患者扫描图像质量前提下，如何合理设置扫描条件，尽量降低辐射剂量。 方法 使用Piranha辐射测量仪测量CBCT在使用F1与未使用F1时射线的半价层。设定不同的扫描模式，使用直径30 cm的有机玻璃模体测量扫描剂量，并使用XVI附带的Catphan503模体测量客观图像质量。在此基础上，研究扫描剂量以及图像质量与扫描条件的关系，提出了适合临床患者的胸部与腹部不同的扫描条件。 结果 使用F1后射束的半价层增加了0.77～0.92 mmAl，扫描剂量明显减少，中心点减少了22%~29%，边缘点减少了41%~45%，皮肤剂量减少显著。图像质量随着扫描剂量的增大而提高。空间分辨力受FOV影响较大，但一般能识别1～2 mm的物体，完全能够满足分辨细小骨结构与标记点的临床要求。图像伪影在使用L20时的大mAs下明显。胸部低剂量的CBCT图像如100 kV，M20，0.5 mAs的扫描条件亦可满足临床要求。腹部则需要使用较大剂量的扫描模式，CBCT图像才达到进行配准的要求。 结论 F1的使用在改善图像质量的前提下降低了扫描剂量，使用新的扫描序列能平衡二者的关系。【Abstract】 Objective To explore the influence of bowtie filtration on absorb dose and half-value layer inaluminum (Al) of cone-beam CT, estimate the image dose under different scan protocol, and establish the relationship between the image quality and the scan protocol after using F1. Methods Piranha was used to measure the HVL. Dose measurements were performed with an 0.6 cc Farmer type ionization chamber with a 30 cm-diam cylindrical shaped water phantoms in 100 and 120 kV with a series of mAs and FOV. CNR, noise and uniformity were measured on the Catphan503 images. Results HVL increased 0.77-0.92 mmAl where XVI generally had more penetrating beams at the similar kV settings. Scanning dose significantly reduced, the center point decreased 22%-29%, the edge with a decrease of 41%-45% which meant a very significant reduction in skin dose. Image quality improved with mAs increase. The spatial resolution mainly changed with FOV. But generally can identify 1-2 mm-diam objects, fully meet the clinical requirements of identify small bone structure and marker. Through this clinical investigation, low-dose CBCT images in chest, such as 100 kV, M20, and 0.5 mAs scanning protocol appeared to be an optimal settings. Abdomen image needed a higher dose to reach the requirements of registration. Conclusion Using F1 under the premise of improving the image quality then reducing the scanning dose and using a new scanning sequence can balance the image quality and scanning dose.
Objective To compare the efficacy of incision healing by abdominal wall closure measure without suturing subcutaneous fat layer and the traditional abdominal wall closure measure. Methods Four hundreds patients underwent operation of abdominal median incision and abdominal paramedian incision from Sep. 2010 to Sep. 2012 in our department were randomly assigned to observation group （n=199） and control group （n=201）. The patients in obser- vation group underwent abdominal wall closure measure without suturing subcutaneous fat layer， and those of control group were subjected to abdominal wall closure by traditional layer suture technique. Comparison of efficacy of incision healing in the 2 groups was performed. Results The incidences of fat liquefication 〔1 （0.5%） vs.18 （9.0%）〕， incision swelling 〔3 （1.5%） vs.16 （8.0%）〕， incision induration 〔1 （0.5%） vs.15 （7.5%）〕， and dehiscence of wound 〔0 （0） vs.9 （4.5%）〕 in observation group were significantly lower than those of control group （P＜0.01）， but there was no significant difference in incidence of subcutaneous hematoma 〔2 （1.0%） vs.0 （0）， P＞0.05〕. The rate of primary healing in obser-vation group was significantly higher than those of control group 〔199 （100%） vs.186 （92.5%）， P＜0.01〕. Duration of abdominal closure 〔（13.0±1.6） min vs.（18.0±2.2） min〕 and postoperative hospital stay 〔（7.7±1.3） days vs.（9.6±1.9） days〕 were all shorter than those of control group （P＜0.01）. Conclusion The abdominal wall closure measure without suturing subcutaneous fat layer is obviously more effective to the traditional layer suture technique， which is a suture way worthy to spread.
Objective To explore the effects and mechanism of autonomic nervous control on the proliferation of human hepatocytes. And to examine the cellular localization of some related receptors expression in human hepatocytes. MethodsNorepinephrine (NE), and its agonist, antagonist, acetylcholine (Ach), and its antagonist have been added to human hepatocyte line L02 and hepatoma cell line Bel7402. Modified MTT assay was employed to test the effects of them on the proliferation of the two cell lines at 4 h, 24 h, 48 h and 72 h. Immuocytochemical staining was used to examine the cellular localization of alpha1Badrenoceptor (α1BAR), β2AR and epidermal growth factor receptor (EGFR) expression in human hepatocyte line L02. ResultsNE potentiated the proliferation of human hepatocyte and hepatoma cell, which was enhanced significantly with dose increased. The proliferative rate of 4 h were higher than that of the other time points (P＜0.05). There were no significant differences between the group of NE combined with propanolol and the group of NE alone. Metaproterenol had no significant effect. Ach significantly inhibited the proliferation of human hepatocyte. Its effect was enhanced with dose increased. Atropine significantly attenuated the inhibitory effect of Ach at 24 h and 48 h (P＜0.05). Scoline alone inhibited hepatocyte proliferation at 24 h, 48 h and 72 h (P＜0.05, P＜0.01). In immunocytochemical staining, there were positive responses to α1BAR, β2AR and EGFR in all cultures. It was observed that the responses to α1BAR, β2AR and EGFR were mainly both cytoplasmic and cell membrane localized. Conclusion NE, the sympathetic neurotransmitter, acts via α1BAR potentiate the proliferation of human hepatocyte and hepatoma cell in the presence of serum. Ach, the vagus neurotransmitter acting via mAchR and nAchR inhibits hepatocyte proliferation.
Objective To investigate the clinicopathological characteristics and surgical treatment of intrathoracic Castleman disease(CD). Methods Clinical data of 14 cases pathologically diagnosed as CD as analysed retrospectively. There were 6 males and 8 females, with an average age of 29 years(17-58). All were undergone surgical resection or biopsy. Among the 12 patients who had unicentric CD, 11 were performed open thoracotomy and lymphadenectomy with posterolateral or sternum approach, and one was treated by video assisted mini thoracotomy(VAMT). For the diagnosis of multicentric CD, one of the 2 patients had video assisted thoracic surgery(VATS) and wedge resection of the lung, and the other had video mediastinoscopy. Results No patient died perioperatively. All were successfully restored except two complications. One had dyspnea in the second postoperative day, as a result of the softening and collapse of bronchial wall in the entrance of the right main bronchus, which revealed by bedside fiberoptic bronchoscopy. One who had lymphadenopathy in the aortopulmonary window suffered from transient hoarseness after surgery. They recovered after symptomatic treatment finally. Regarding pathological classification, there were 11 cases of hyaline vascular type, 2 cases of plasma cell type and 1 case of mixed cellularity type. 13 cases were followed up for 8-110 months and longterm survive was achieved. No recurrence was observed in the 11 cases with unicentric CD and no relapse was occurred in the 2 cases with multicentric CD. Conclusion Both freezing pathology during operation and paraffin pathology postoperation are important for establishing the diagnosis. For unicentric CD, the clinical symptoms are significantly alleviated and it can be universally cured after operation. Multicentric CD needs multiple therapies after the diagnostic procedure and close follow-up.