Objective To systematically review the efficacy of chlorhexidine versus povidone iodine in the prevention of wound infections after surgeries by meta-analysis. Methods All randomized controlled trials comparing these two disinfectants were searched from databases of PubMed, The Cochrane Library (Issue 3, 2016), EMbase, WanFang Data, VIP and CNKI from inception to August 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 14 randomized controlled trials were included. The results of meta-analysis showed that the chlorhexidine group had significantly lower rates in any surgical site infection (RR=0.71, 95% CI 0.58 to 0.88,P=0.001) and superficial incisional infection (RR=0.66, 95% CI 0.48 to 0.91,P=0.01) when compared with povidone iodine group. However, there were no significant differences in deep incisional infection (RR=0.51, 95% CI 0.23 to 1.11,P=0.09) and organ-space infection (RR=0.97, 95% CI 0.53 to 1.76,P=0.92) between the two groups. Furthermore, subgroup analysis revealed differences in any surgical site infection and superficial incisional infection could only be found in surgeries possibly contaminated. Conclusion Chlorhexidine may be superior in decreasing the incidence of infection in probably contaminated surgery.
Crohn’s disease (CD) is one of inflammatory bowel diseases, characterized by lifelong relapsing-remitting clinical course. The choice of treatment protocols is based on the comprehensive evaluation of the disease. And the treatment protocols should be adjusted according to the response to the treatment and the drug tolerance. Repeated assessment of the activity of intestinal inflammation is very necessary. Each of endoscopy, Crohn’s Disease Activity Index, CT, magnetic resonance enterography, and ultrasonography (US) has its own disadvantages. US is widely used in clinical practice because of its no radiation, convenience, low cost, and high degree of patient tolerance. The two-dimensional ultrasound, Doppler ultrasound, elastosonography, and contrast-enhanced ultrasonography each provides some effective parameters for evaluation of CD activity. Some parameters are of high value, such as bowl wall thichness, bowl wall stratification, color Doppler signal, strain ratio, and relative enhancement, etc. The values of some parameters are disputed, such as the blood flow of superior mesenteric artery, time to peak, etc. Some studies combine several ultrasound parameters and calculate their respective weights to obtain an ultrasound scoring method. US, as a valid tool to evaluate CD activity, provides valuable help in solving clinical problems such as evaluation of therapeutic effect, mucosal healing, and postoperative recurrence.
Objective To explore the feasibility of transluminal dual plane ultrasound (TDPU) in evaluating the structure and function of pelvic floor muscle. Methods Non anorectal diseases patients who visited the Department of Medical Ultrasound, West China Hospital of Sichuan University, medical staff and medical staff’s relatives volunteers between May and November 2022 were selected. According to the criteria for ultrasound diagnosis of pelvic organ prolapse (POP) and the pelvic organ prolapse quantification (POP-Q) scoring criteria, the subjects were divided into normal group and POP group. The changes of the thickness of the left and right puborectalis muscle (PRM), the internal anal sphincter (IAS) and the external anal sphincter (EAS) at 3-, 6- and 9-o’clock, the depth and height of the perineal body (PB) were compared, and the changes of the elastic Young’s modulus of PRM, EAS and PB were compared through real-time shear wave elastography. Results A total of 192 subjects were included, including 140 in the normal group and 52 in the POP group. There were statistically significant differences between the POP group and the normal group in terms of gestational frequency, parity, and history of vaginal delivery (P<0.05). There was no statistically significant difference in age, body mass index, menopausal history, and neonatal weight between the two groups (P>0.05). Under the condition of resting and maximum anal constriction, the thickness of PRM on the left and right sides of POP group was not significantly different from that of the normal group (P>0.05), but the elastic Young’s modulus of PRM on the left and right sides were lower than that of the normal group (P<0.05). At resting and maximum anal constriction, there was no significant difference in IAS thickness between the POP group and the normal group at 3-, 6- and 9-o’clock (P>0.05). At resting and maximum anal constriction, the thickness of deep and subcutaneous parts of EAS at 6-o’clock and the subcutaneous part of EAS at 9-o’clock in the POP group were smaller than those in the normal group (P<0.05). At resting and maximum anal constriction, the elastic Young’s modulus of EAS at 3-, 6- and 9-o’clock were lower than those in the normal group (P<0.05). There was no significant difference in the depth and height of PB between the POP group and the normal group at resting and maximum anal constriction (P>0.05). The elastic Young’s modulus of PB in the POP group was lower than that of the normal group (P<0.05). Under the condition of maximum anal constriction, the thickness of deep and subcutaneous parts of EAS at 3-o’clock in the POP group were lower than those in the normal group (P<0.05). Conclusion TDPU can quantitatively evaluate the structure and function of pelvic floor muscle through different states of resting and maximum anal constriction, and also can provide ultrasonic basis for the diagnosis and treatment of female pelvic floor dysfunction diseases.
Transrectal contrast-enhanced ultrasound (CEUS) is an important examination for rectal tumors. The inhomogeneity of the CEUS images has important clinical significance. However, there is no objective method to evaluate this index. In this study, a method based on gray-level co-occurrence matrix (GLCM) is proposed to extract texture features of images and grade these images according the inhomogeneity. Specific processes include compressing the gray level of the image, calculating the texture statistics of gray level co-occurrence matrix, combining feature selection and principal component analysis (PCA) for dimensionality reduction, and training and validating quadratic discriminant analysis (QDA). After ten cross-validation, the overall accuracy rate of machine classification was 87.01%, and the accuracy of each level was as follows: Grade Ⅰ 52.94%, Grade Ⅱ 96.48% and Grade Ⅲ 92.35% respectively. The proposed method has high accuracy in judging grade Ⅱ and Ⅲ images, which can help to identify the grade of inhomogeneity of contrast-enhanced ultrasound images of rectal tumors, and may be used to assist clinical doctors in judging the grade of inhomogeneity of contrast-enhanced ultrasound of rectal tumors.