Percutaneous management in hepatic alveolar echinococcosis: A sum of single center experiences and a brief overview of the literature

BACKGROUND Hepatic alveolar echinococcosis(HAE) is a serious zoonotic infection that affects humans. It may have a tumor-like appearance at times. Percutaneous treatment of HAE patients is extremely relaxing for them. HAE is a significant human zoonotic infection caused by the fox tapeworm Echinococcus Multilocularis larvae. It possesses the characteristics of an invasive tumor-like lesion due to its infiltrative growth pattern and protracted incubation period. The disease is endemic over centra...     

Atherogenic Indices Can Predict Atherosclerosis in Patients with Sarcoidosis

Background:Sarcoidosis, a multisystemic disease of unknown etiology, is characterized by non-caseating granulomatous inflammation. This study aimed to investigate the efficiency of atherogenic indices and ultrasonographic evaluation of carotid artery on predicting atherosclerosis in patients with sarcoidosis.Methods:The study included 44 subjects followed with diagnosis of sarcoidosis and 53 age and gender matched healthy subjects as controls. Laboratory findings, pulmonary function tests and carotid artery ultrasonography of all participants were evaluated.Results:Of the participants with sarcoidosis 70.5% was female and the mean age was 35.36±7.18 years, while 64.2% of the control group were female and the mean age was 33.58±8.13 years (P=0.511 and P=0.191, respectively). High-density-lipoprotein cholesterol level in the sarcoidosis group was significantly lower than that of the control group (P=0.017), while other cholesterol levels were higher than those of the controls (P<0.05). Intima-media thickness (IMT) and peak systolic velocity (PSV) of carotid artery were higher in patients with sarcoidosis (P<0.001 and P=0.009, respectively). Atherogenic indices (Atherogenic Index (AI), Atherogenic Coefficient (AC) and Cardiogenic Risk Ratio (CRR)) were higher in sarcoidosis group compared to the controls (P<0.001, for all parameters). IMT was positively correlated with PSV, AI, AC, and CRR. A positive correlation between PSV and atherogenic indices was also detected.Conclusions:Sarcoidosis may be a predisposing factor for atherosclerosis. Atherogenic indices, IMT of carotid artery and PSV might be considered predictors for atherosclerosis and cardiovascular diseases in asymptomatic sarcoidosis patients.     

Symbiotic collision tumour of the scalp: squamous cell carcinoma and malignant melanoma

Cutaneous collision tumours are the co-existence of two tumours of different histopathological morphologies that coincide at the same or adjacent anatomical sites. A large scalp nodule excised from a 70 year-old man revealed a collision tumour composed of cells of squamous carcinoma (SCC) and malignant melanoma. Immunohistochemistry using dual staining for melanoma and squamous cell carcinoma demonstrated an unusual pattern; nests of melanoma cells surrounded by a layer of squamous carcinoma cells. The unique architecture observed in the case suggested a relationship between the two tumours.     

Effect of pre- and postganglionic nerve divisions on normal postnatal and hydrocortisone-induced development of small intensely fluorescent cells in rat superior cervical ganglion

The left superior cervical ganglion of 3- or 23-day-old rats was subjected to pre- and/or postganglionic nerve division or sham operation, while the right ganglion was left intact. The animals were killed 20 or 60 days after the operation. Some animals were injected with 20 mg/kg hydrocortisone daily for 7 days and killed on the 8th day.Fluorescence microscopical examination revealed a normal postnatal increase in the number of small intensely fluorescent cells/ganglion after pre- or postganglionic nerve division, in spite of marked decreases in the volume of the operated ganglia. Combined pre- and postganglionic nerve division, which caused a dramatic loss of ganglion volume, entirely prevented the postnatal increase in the number of small intensely fluorescent cells. Hydrocortisone caused a large increase in the number of small intensely fluorescent cells both in intact and operated ganglia, including those in whom both pre- and postganglionic nerves had been divided.It is concluded that combined pre- and postganglionic denervation, in contrast to either operation alone, prevents the normal proliferation of the small intensely fluorescent cells possibly by causing an extensive loss of principal nerve cells which deprives the small intensely fluorescent cells of their normal contacts with the principal cells. Since the increase in the number of small intensely fluorescent cells due to hydrocortisone injections was not prevented by pre- and postganglionic denervation it must be due to a mechanism different from that responsible for the formation of small intensely fluorescent cells during normal postnatal development.     

Effects of N-acetylcysteine on acute necrotizing pancreatitis in rats

The aim of this study was to investigate the influence of N-acetylcysteine (NAC) on acute necrotizing pancreatitis (ANP) induced by glycodeoxycholic acid in rats. The induction of ANP resulted in significant increase in mortality rate, pancreatic necrosis and serum activity of amylase, alanine aspartate transferase (ALT), interleukin-6 (IL-6), lactate dehydrogenase (LDH) in bronchoalveolar lavage (BAL) fluid, serum concentration of urea, tissue activity of myeloperoxidase (MPO) and malondialdehyde (MDA) in the pancreas and lung, and significant decrease of concentrations of calcium, blood pressure, urine output and pO(2). The use of NAC inhibited the changes in urine output, pO(2), tissue activity of MPO and MDA in pancreas and lungs, and the serum activity of IL-6, ALT, and serum concentrations of urea and calcium. NAC reduced the mortality and pancreatic damage. The use of NAC has a beneficial effect on the course of ANP in rats. It may be used in the treatment of acute pancreatitis.     

心脏穿透伤224例的临床分型和处理

目的　为了比较不同时期心脏穿透伤 (PCT)的流行病学、诊治疗效的发展趋势 ,探讨临床分型对 PCT救治的指导意义以及影响预后的因素。　方法　对 15家三级医院 1990年 1月～ 2 0 0 1年 10月收治的 PCT共 2 2 4例进行回顾性研究 ,按年代的先后将其分为两组 ,组 1(1990年 1月～ 1995年 12月 ,92例 )和组 2 (1996年 1月～ 2 0 0 1年 10月 ,132例 ) ;并根据入院时的临床表现分为亚临床型、临床型 ,后者又分为心脏压塞型和失血休克型。　结果　亚临床型 5 3例 ,其院前时间 (T1)、入院时修订创伤计分 1(RTS1)分别为 0 .74± 0 .5 4小时和 5 .35± 0 .87;临床型171例 ,T1、RTS1分别为 1.5 0± 2 .6 0小时和 4 .2 9± 1.6 4 (P<0 .0 5 ) ,两型的麻醉时修订创伤计分 (RTS2 )、损伤严重度评分 (ISS)差别无显著性意义 (P>0 .0 5 )。全组死亡 36例 ,总死亡率 16 .0 7%。其中亚临床型死亡 2例 ,心脏压塞型 9例 ,失血休克型 2 5例。组 1死亡 2 0例 ,死亡率为 2 1.74 % ;组 2死亡 16例 ,死亡率下降至 12 .12 % (P<0 .0 1)。　结论　 PCT的发生率呈逐年增高趋势 ,要提高 PCT的抢救成功率 ,应加强院前救治和转运 ,简化诊断方法 ,尽早开胸手术治疗。临床分型对救治具有指导意义。     

电子胃镜在肥胖代谢手术围手术期的应用

当代社会经济快速发展,人们生活水平改善迅速,能量过剩导致的肥胖症发病率在世界范围内逐年升高,而我国肥胖症患者人数已跃居世界第一[1].肥胖代谢手术作为治疗肥胖症的重要手段之一,已在全球范围内被广泛应用[2-4].我国的肥胖代谢手术,依靠长期科普及良好的减重效果逐渐被需要做手术的肥胖症患者所接受,手术例数也呈逐年上升趋势...     

Salbutamol‐induced Decrease in Augmentation Index is Related to the Parallel Increase in Heart Rate

The change in augmentation index following salbutamol inhalation has been applied to evaluate endothelial function. We examined the contribution of salbutamol‐induced increase in heart rate to the observed decrease in augmentation index. Haemodynamics were recorded using whole‐body impedance cardiography and continuous pulse wave analysis from tonometric radial blood pressure. All subjects (n = 335, mean age 46, body mass index 26, 48% men) were without medications with cardiovascular influences. The effects of salbutamol inhalation (0.4 mg) versus the endothelium‐independent agent nitroglycerin resoriblet (0.25 mg) were examined during passive head‐up tilt, as the haemodynamic influences of these compounds depend on body position. Salbutamol decreased augmentation index by ~3‐4% units in supine and upright positions. Although salbutamol moderately increased cardiac index (+4.5%) and decreased systemic vascular resistance (?8.5%), the significant haemodynamic explanatory factors for decreased augmentation index in multivariate analysis were increased supine heart rate, and increased upright heart rate and decreased ejection duration (p < 0.001 for all, r² = 0.36–0.37). Sublingual nitroglycerin decreased supine and upright augmentation index by ~15% units and ~23% units, respectively. The haemodynamic explanatory factors for these changes in multivariate analysis were increased heart rate, reduced ejection duration and reduced systemic vascular resistance (p ≤ 0.021 for all, r² = 0.22–0.34). In conclusion, the lowering influence of salbutamol on augmentation index may be largely explained by increased heart rate, suggesting that this effect may not predominantly reflect endothelial function.     

[Ca^2＋]i change in hippocampal neurons influenced by preconditioning of etomidate fat emulsion following cerebral ischemia in rats

BACKGROUND: It is known that intravenous anesthetic etomidate fat emulsion has cerebral protection. Now many scholars focus on the research of its cerebral protection from molecular biology, but the mechanism of cerebral protection is still fully unclear. OBJECTIVE: To observe the influence of etomidate fat emulsion on the [Ca2+]i in hippocampal neurons during the transient cerebral ischemia injury in rats. DESIGN: Randomized controlled observation. SETTING: Weifang Medical College. MATERIALS: This study was carried out in the functional laboratory of Weifang Medical College between October 2005 and March 2006. Twenty-four male healthy Wistar rats, aged 3 to 4 months, were involved. Etomidate fat emulsion was provided by the limited company of En-hua Medical Bloc in Jiangsu Province (code of H20020511) and the other agents and materials were provided by Laboratory Center of Weifang Medical College. METHODS: The 24 Wistar rats were randomized into 3 groups: sham-operation group, model group and etomidate preconditioning group, with 8 rats in each. Rat models of transient cerebral ischemia injury were made by the ligation of bilateral carotid arteries combined with descending blood pressure in the latter two groups. Before ischemia (ligation of bilateral common carotid artery), rats in the etomidate preconditioning group were intraperitoneally injected with 12 mg/kg etomidate fat emulsion and then persistently intraperitoneally injected with etomidate fat emulsion at 1.0 mg/kg per minute. Rats in the model group were not administrated. Rats in the sham-operation group were only performed bilateral common carotid artery isolation. When rats were modeled, their brain tissues were quickly taken out and detected. MAIN OUTCOME MEASURES: Change of the fluorescence pixel value of the [Ca2+]i in each group by the laser scanning confocal microscope. RESULTS: Twenty-four rats were involved in the final analysis. Fluorescence pixel value in the sham-operation group was in the low level. Fluorescence pixel value in the model group was significantly higher than that in the sham-operation group (P < 0.01). Fluorescence pixel value in the etomidate preconditioning group was significantly lower than that in the model group (P < 0.01). CONCLUSION: The protection of etomidate fat emulsion to the transient cerebral ischemic injury in rats is associated with the inhibition to the increase of [Ca2+]i to some extent.     

Investigation of vibration‐induced artifact in clinical diffusion‐weighted imaging of pediatric subjects

It has been reported that mechanical vibrations of the magnetic resonance imaging scanner could produce spurious signal dropouts in diffusion‐weighted images resulting in artifactual anisotropy in certain regions of the brain with red appearance in the Directionally Encoded Color maps. We performed a review of the frequency of this artifact across pediatric studies, noting differences by scanner manufacturer, acquisition protocol, as well as weight and position of the subject. We also evaluated the ability of automated and quantitative methods to detect this artifact. We found that the artifact may be present in over 50% of data in certain protocols and is not limited to one scanner manufacturer. While a specific scanner had the highest incidence, low body weight and positioning were also associated with appearance of the artifact for both scanner types evaluated, making children potentially more susceptible than adults. Visual inspection remains the best method for artifact identification. Software for automated detection showed very low sensitivity (10%). The artifact may present inconsistently in longitudinal studies. We discuss a published case report that has been widely cited and used as evidence to set policy about diagnostic criteria for determining vegetative state. That report attributed longitudinal changes in anisotropy to white matter plasticity without considering the possibility that the changes were caused by this artifact. Our study underscores the need to check for the presence of this artifact in clinical studies, analyzes circumstances for when it may be more likely to occur, and suggests simple strategies to identify and potentially avoid its effects. Hum Brain Mapp 36:4745–4757, 2015. © 2015 Wiley Periodicals, Inc.