Endoscopic ultrasonography guided drainage:Summary of consortium meeting,May 21,2012,San Diego,California

Endoscopic retrograde cholangiopancreatography(ERCP) is the preferred procedure for biliary and pancreatic drainage.While ERCP is successful in about 95% of cases,a small subset of cases are unsuccessful due to altered anatomy,peri-ampullary pathology,or malignant obstruction.Endoscopic ultrasound-guided drainage is a promising technique for biliary,pancreatic and recently gallbladder decompression,which provides multiple advantages over percutaneous or surgical biliary drainage.Multiple retrospective and some prospective studies have shown endoscopic ultrasoundguided drainage to be safe and effective.Based on the currently reported literature,regardless of the approach,the cumulative success rate is 84%-93% with an overall complication rate of 16%-35%.endoscopic ultrasoundguided drainage seems a viable therapeutic modality for failed conventional drainage when performed by highly skilled advanced endoscopists at tertiary centers with expertise in both echo-endoscopy and therapeutic endoscopy     

经腹彩色多普勒超声在前置胎盘并发胎盘植入诊断中的临床价值

目的探讨经腹彩色多普勒超声在前置胎盘并发胎盘植入诊断中的临床价值。方法选取2012年4月~2015年4月在我院接受治疗的前置胎盘合并胎盘植入患者共100例,采用经腹彩色多普勒对所有患者进行检查,分析检查结果。结果经腹彩色多普勒超声诊断后,共诊断为前置胎盘并发胎盘植入的患者共52例,准确率为98.1%,漏诊患者1例,漏诊率为1.9%。结论采用经腹彩色多普勒超声对产妇的前置胎盘并发胎盘植入疾病进行诊断具有良好的临床价值。     

脂肪肝超声诊断结果探析

目的：本文将对体检人群进行临床资料回顾性分析，并探讨脂肪肝在彩色多普勒超声筛查结果，为临床准确判断脂肪肝疾病提供可靠依据。方法对2012年10月～2013年4月山东省阳谷县疾病预防控制中心进行体检的2456例进行临床资料回顾性分析，所有受检者均给予彩色多普勒超声检查，观察并记录所有体检人群超声影像检查结果，并进行统计学分析，得出结论。结果在2456例体检人群中检出脂肪肝人数为365例，发病率为6.86%，其中弥漫性脂肪肝患者为339例、非均匀性脂肪肝患者为26例。结论彩色多普勒检查是目前常用的无创性脂肪肝检查方式，具有无痛苦、操作方便、准确性高等特点。临床应根据患者彩色多普勒检查结果以及各项辅助检查措施对其病情进行综合准确判断，若确诊为脂肪肝应及早进行有效治疗，从而达到更为满意的临床治疗效果，保障患者生活质量与生命安全，值得临床推广应用。     

Outcomes of Fluoroscopy-Guided Percutaneous High Ligation of the Great Saphenous Vein Combined With Foam Sclerotherapy for Symptomatic Great Saphenous Veins

PurposeTo evaluate the effectiveness and safety of fluoroscopy-guided percutaneous high ligation (FPHL) combined with fluoroscopy-guided foam sclerotherapy (FGFS) to treat varicose veins of the great saphenous veins (GSVs).Materials and MethodsThis was a retrospective study of 113 patients (mean age, 62.1 ± 10.8 years; 60 men) with varicose veins of the GSVs (133 limbs) that were treated with FPHL combined with FGFS between April 1 and October 31, 2019. Demographic and clinical data were collected from these patients before the FPHL procedure, after which FGFS was performed. The preterminal GSV was ligated percutaneously by a percutaneously-positioned polypropylene ligature under fluoroscopic guidance. The outcome of ligation was confirmed by venography. Then, foam sclerotherapy was performed under fluoroscopy. At 1-year follow-up, GSV occlusion was evaluated by ultrasound. The venous clinical severity scores (VCSSs) were compared between the preoperative and 1-year follow-up periods.ResultsThe technical success rate was 100% (133 limbs). Complete 12-month follow-up was available for 112 limbs (84.2%) and 103 of these limbs (92.0%) remained occluded during this period. The VCSS improved from 4.71 ± 2.15 to 0.74 ± 0.60 (V = 6328, P < .001). During follow-up, there were 16 limbs with thrombophlebitis and 38 limbs with saphenous junction pain; these events were alleviated within 2 weeks of the procedure. There was no deep venous thrombosis or other severe adverse events.ConclusionsFPHL combined with FGFS to treat varicose veins in the GSVs achieved an occlusion rate of 92% and improved the clinical symptoms within 1 year; this minimally-invasive procedure was safe and effective.     

Bronchogenic cyst of the stomach:A case report

BACKGROUND Gastric bronchogenic cysts(BCs)are extremely rare cystic masses caused by abnormal development of the respiratory system during the embryonic period.Gastric bronchial cysts are rare lesions first reported in 1956;as of 2019,only 37 cases are available in the MEDLINE/PubMed online databases.BCs usually have no clinical symptoms in the early stage,and their imaging findings also lack specificity.Therefore,they are difficult to diagnose before histopathological examination.CASE SUMMARY A 55-year-old woman presented at our hospital with intermittent epigastric pain.She had a slightly high level of serum carbohydrate antigen 72-4(CA 72-4).Endoscopic ultrasound found that a cystic mass originated from the submucosa of the posterior gastric wall near the cardia,indicating a diagnosis of cystic hygroma of the stomach.Furthermore,a computed tomography scan demonstrated a quasi-circular cystic mass closely related to the lesser curvature of the gastric fundus with a low density.Because the imaging examinations did not suggest a malignancy and the patient required complete resection,she underwent laparoscopic surgery.As an intraoperative finding,this cystic lesion was located in the posterior wall of the fundus and contained some yellow viscous liquid.Finally,the pathologists verified that the cyst in the fundus was a gastric BC.The patient recovered well with normal CA 72-4 levels,and her course was uneventful at 10 mo.CONCLUSION This is a valuable report as it describes an extremely rare case of gastric BC.Moreover,this is the first case of BC to present with elevated CA 72-4 levels.     

糖尿病患者足部皮温与下肢动脉彩色多普勒超声的相关性研究

目的:探讨糖尿病患者足部皮温与下肢动脉彩色多普勒超声(彩超)的关系。方法:测定156例糖尿病患者的双足皮肤温度差,利用动脉彩超检查双下肢动脉并进行狭窄程度分级,进行相关分析。结果:双足皮肤温度差<1℃的患者为41例(26.3%),温度差>2.2℃的患者为52例(33.3%),温度差在两者之间的患者为63例(40.4%),下肢动脉彩超狭窄程度随皮肤温度差增大而严重(P<0.005)。结论:足部皮温检测能反映糖尿病患者下肢动脉彩超的变化,是预测血管狭窄程度的一个经济、简便、无创的方法。     

Color Doppler Twinkling Artifact in Diagnosis of Tuberculous Pleuritis: A Comparison with Gray-Scale Ultrasonography and Computed Tomography

The aim of this study was to determine whether twinkling artifact (TA) detected on color Doppler ultrasonography can effectively determine the presence of pleural calcification compared with computed tomography (CT) and differentiate tuberculous pleuritis (TP) and cancerous pleuritis (CP). One hundred six cases of TP and 26 cases of CP were scanned using gray-scale ultrasonography (GSU) and TA to determine the presence of pleural calcification. With CT as the reference standard, 63.3% and 79.6% of patients with pleural calcification were identified with GSU and TA, respectively. The detection rate of TA was higher than that of GSU (p?=?0.039). For the whole study population, 37.1% were identified as having pleural calcification with CT, significantly higher than the proportion detected with GSU (25.8%, p?=?0.001), but not different from that detected with TA (41.7%, p?=?0.327). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of TA were 79.6%, 80.7%, 80.3%, 70.9% and 87.0%, respectively. The detection rate of TA was significantly higher than that of GSU (p?<0.001). When GSU was combined with TA (GSUTA), the positive rate in the TP group was significantly higher than that in the CP group (χ²?<?0.001). In conclusion, TA is comparable to CT and more sensitive than GSU in the detection of pleural calcification. Evaluation for GSUTA on pleura may help to differentiate TP from CP.     

Properties of a color-changeable chewing gum used to evaluate masticatory performance

PurposeTo clarify the basic properties of a color-changeable chewing gum to determine its applicability to evaluations of masticatory performance under different types of dental status.MethodsTen participants with natural dentition aged 26–30 years chewed gum that changes color during several chewing strokes over five repetitions. Changes in color were assessed using a colorimeter, and then L*, a*, and b* values in the CIELAB color system were quantified. Relationships between chewing progression and color changes were assessed using regression analysis and the reliability of color changes was assessed using intraclass correlation coefficients. We then measured 42 dentate participants (age, 22–31 years) and 47 complete denture wearers (age, 44–90 years) to determine the detectability of masticatory performance under two types of dental status.ResultsRegression between the number of chewing strokes and the difference between two colors was non-linear. The intraclass correlation coefficients were highest between 60 and 160 chewing strokes. Dentate and edentulous groups significantly differed (Wilcoxon rank sum test) and values were widely distributed within each group.ConclusionsThe color of the chewing gum changed over a wide range, which was sufficient to evaluate the masticatory performance of individuals with natural dentition and those with complete dentures. Changes in the color values of the gum reliably reflected masticatory performance. These findings indicate that the color-changeable chewing gum will be useful for evaluating masticatory performance under any dental status.     

彩色多普勒超声诊断吸毒者腹股沟区损伤39例分析

目的探讨吸毒者反复不洁注射致腹股沟区损伤的彩色多普勒超声影像特征。方法对39例腹股沟区反复不洁注射出现下肢活动受限、腹股沟区肿块、血管杂音的患者行彩色多普勒超声检查。结果检出动脉血栓、动静脉瘘、假性动脉瘤、脓肿、血肿、淋巴结肿大,与临床和血管造影或手术结果完全符合(39/39)。结论彩色多普勒对吸毒者反复不洁注射致腹股沟区损伤有较高的诊断价值。