Objective To understand and analyze technique development of magnetic resonance elastography (MRE) and its application in chronic liver disease. Method The relevant literatures about the application of MRE in the field of chronic liver disease were reviewed. Results The liver fibrosis was a common pathway of chronic liver disease, which would progress to cirrhosis of the liver if untreated. The diagnosis and assessment of fibrosis was important in the treatment of patients with chronic liver disease. The liver biopsy was considered to be the reference standard for clinical assessment of liver fibrosis. However, this technique was invasive and still had inevitable drawbacks in the clinical practice. With the update of the imaging technology and equipment, the MRE had been developed as a safe and noninvasive examination method for the evaluation of liver fibrosis in the chronic liver disease, early diagnosis of nonalcoholic fatty liver disease, evaluation of focal liver lesions, and other clinical applications. Conclusion MRE is currently regarded as an attractive noninvasive technique in management of chronic liver disease.
ObjectiveTo observe the effect and significance of autologous fibrin clot on tendon-bone healing after anterior cruciate ligament (ACL) reconstruction.MethodsBetween October 2014 and January 2016, 34 patients (34 knees) with ACL injury were enrolled in the study. During ACL reconstruction, autologous fibrin clot was used in 17 cases (trial group) and was not used in 17 cases (control group). The anterior drawer test, Lachman test, and axial displa-cement test were positive in 2 groups before operation. There was no significant difference in gender, age, causes of injury, injury side, disease cause, and preoperative knee joint activity, Lysholm score, and American Hospital for Special Surgery (HSS) score between 2 groups (P>0.05), with comparable. The results of anterior drawer test, Lachman test, and axial displacement test were recorded and compared between 2 groups after operation. The knee joint activity, Lysholm score, and HSS score were used to evaluate the knee function recovery at 6, 24, and 48 weeks after operation; the graft signal intensity, graft signal to noise ratio, bone tunnel expansion, and graft tendon-bone node T2 value were measured.ResultsAll patients were followed up 48 weeks. Surgical incision healed at stage I. No joint infection and joint adhesion occurred. The drawer test, Lachman test, and axial shift test were negative in 2 groups. At 6, 24, and 48 weeks after operation, the Lysholm score of trial group was significantly higher than that of control group (P<0.05); there was no significant difference in knee joint activity between 2 groups (P>0.05). The HSS score of trial group was significantly higher than that of control group at 24 and 48 weeks (P<0.05), but no significant difference was found at 6 weeks (P>0.05). MRI measu-rement showed that there was significant difference in graft signal intensity, bone tunnel expansion, and graft signal to noise ratio between 2 groups at 6, 24, and 48 weeks after operation (P<0.05). There was no significant difference in graft tendon-bone node T2 value between 2 groups (P>0.05) at 48 weeks after operation, but difference was significant at 6 and 24 weeks (P<0.05).ConclusionAutologous fibrin clot can effectively enhance graft revascularization, and accelerate the process of tendon-bone healing after ACL reconstruction.
ObjectiveTo investigate the perioperative results and safety of minimally invasive direct coronary artery bypass grafting (MIDCAB) treatment of anterior descending artery disease through a small left thoracic incision assisted by thoracoscopy. MethodsThe clinical data of 92 patients who received MIDCAB in our hospital from May 2014 to October 2018 were retrospectively analyzed, including 72 (78.26%) males aged 42-78 (61.2±7.48) years, and 20 (21.74%) females aged 30-80 (61.30±12.26) years. The perioperative complications, blood product use, left heart function changes, ventilator use time, ICU stay, hospital stay and other indicators were analyzed. ResultsTwo (2.17%) patients were transferred to thoracotomy, 5 (5.43%) patients received blood products during the operation, 2 (2.17%) were subjected to secondary thoracotomy to stop bleeding, 4 (4.34%) had postoperative hypoxemia and 1 (1.08%) was reintubated. The ventilator use time was 3-227 (22.35±35.39) hours, the ICU stay was 16-777 (78.85±108.62) hours, and the postoperative hospital stay was 2-36 (8.86±6.05) days. One (1.08%) patient died in hospital. ConclusionMIDCAB for anterior descending artery disease has good perioperative results, especially for solitary anterior descending artery disease, which can reduce the use of blood products, and shorten the time of ventilator use after operation, ICU stay and hospital stay.
Objective To investigate the optimal diagnosis and treatment strategy of occult carcinoma of the thyroid (OCT) with neck lymph node metastasis as the first symptom. Method In order to discuss the optimal diagnosis and treatment strategy of OCT with neck lymph node metastasis as the first symptom, we collected 35 cases and analyzed their characteristics, diagnostic methods, operative schemes, metastasis situation, and death situation. Results Of the 35 cases, 28 cases went to hospital because of swollen lymph nodes, and other 7 cases were discovered by color Doppler ultrasound in medical examination. Thyroid nodules were found by color Doppler ultrasound in 32 cases, 3 cases were found no thyroid nodule. Lymph node of 23 cases were determined by ultrasound-guided fine-needle aspiration biopsy (US-FNAB), and 16 cases (69.56%) were diagnosed as metastasis of thyroid carcinoma or suspicious metastasis by US-FNAB. Thyroid biopsy were done in 21 cases, and 11 cases (52.38%) were diagnosed as thyroid carcinoma or suspicious thyroid carcinoma by fine needle aspiration biopsy. Of the 35 cases, 19 cases were performed total thyroidectomy and functional neck lymph node dissection, 11 cases were performed resection of unilateral thyroid and isthmus and regional neck lymph node dissection, 5 cases were performed nonstandard operations. All cases were followed up for 3–10 years after operation, and the median time was 7-year. During follow up period, 10 cases suffered from reccurrence. Among them, 3 cases reoccurred in the nonstandard operation group, 5 cases reoccurred in resection of unilateral thyroid and isthmus and regional neck lymph node dissection group, 3 cases reoccurred in total thyroidectomy and functional neck lymph node dissection group. There were 3 cases died. Among them, there was 1 case in each group of nonstandard operation group, resection of unilateral thyroid and isthmus and regional neck lymph node dissection group, and total thyroidectomy and functional neck lymph node dissection group. The recurrence rate of total thyroidectomy and functional neck lymph node dissection group was markedly lower than those of resection of unilateral thyroid and isthmus and regional neck dissection group (χ2=4.751,P<0.05) and nonstandard operation group (χ2=5.874,P<0.05). While there was no significance difference of the recurrence rate between the resection of unilateral thyroid and isthmus and regional neck dissection group and nonstandard operation group (χ2=0.291,P>0.05). There was no significance difference in the mortality among the three groups (P>0.05). Conclusion US-FNAB and intraoperation rapid frozen pathological section are important methods for diagnosis of OCT with neck lymph node metastasis as the first symptom, and standard operation is an principal treatment method for it.
ObjectiveTo investigate the strategy adjustment of breast cancer surgery management process during the outbreak of novel coronavirus pneumonia (NCP), and to summarize the experience.MethodsBased on "Pneumonitis Diagnosis and Treatment Plan for Novel Coronavirus Infection (Fifth Trial Version)" and "Surgery Work System During the Prevention and Control of Novel Coronavirus Infection in Mianyang Central Hospital (Second Edition)", the breast surgery department adjusted strategies and plans for breast cancer surgery during the epidemic.ResultsFrom January 25, 2020 to February 11, 2020, 8 cases of breast cancer surgery were performed in our hospital. They were all females, with an average age of 45 years. Five patients underwent modified radical mastectomy, 2 patients underwent breast-conserving surgery plus sentinel lymph nodes biopsy, and 1 case underwent breast-conserving surgery plus axillary lymph node dissection. All 8 patients were diagnosed as invasive ductal carcinoma of breast by hollow needle biopsy. All patients recovered smoothly after surgery, no complications occurred, and they were discharged as planned. No patients or medical staff showed NCP exposure and infection.ConclusionDuring the NCP epidemic, breast cancer surgery can be performed and the epidemic can be effectively prevented and controlled by adjusting the work flow and strategy.