CT引导下肺穿刺定位装置研制

目前CT引导下的肺穿刺活检采用徒手操作，术中需多次CT扫描验证，穿刺途径的选择和穿刺的进行局限于某一个二维平面内，手术时间长，重复穿刺次率较高，患者遭受X辐射量大，并有一定的气胸、出血甚至致命的并发症。本研究设计了一款CT引导下穿刺定位装置，可以实现三维空间内自由定位，能够定量地调整穿刺角度，克服了传统定位的模糊性和不确定性；装置还提供穿刺方向的引导，同时避免人手抖动对穿刺方向造成偏差，提高穿刺成功率，减少穿刺时间和CT扫描次数。该装置小巧轻便，操作便捷，易于推广使用。     

Fine‐tuning the criteria for strip biopsy and endoscopic submucosal dissection improves the outcome of early gastric carcinoma treatment

Background and Aim: Strip biopsy and endoscopic submucosal dissection (ESD) have been developed as a local treatment for early gastric cancer (EGC). However, the lesion criteria for the use of ESD, rather than strip biopsy, remain to be elucidated. Methods: On the basis of reviews of literature and our observations concerning the outcome of strip biopsy, we set the criteria for selecting strip biopsy and ESD as follows. The indications for strip biopsy were lesions less than 10 mm in size and located in the anterior wall or greater curvature of the lower and middle stomach. ESD was indicated for all other lesions. The validity of the criteria was then analyzed prospectively in 156 patients. The rate of en bloc R0 resection and local recurrence were evaluated. Results: Subsequently, 156 lesions were divided according to the criteria and were endoscopically resected by strip biopsy (n = 13) or ESD (n = 143). The en bloc R0 resection rates for the whole group and the strip biopsy and ESD groups was 93.5% (146/156), 92.3% (12/13), and 93.7% (134/143), respectively. None of the patients had suffered from local recurrence in either the strip biopsy or ESD groups. Conclusion: The validity of our criteria for selecting strip biopsy and ESD was verified. Our criteria exploit the advantages of both procedures and obtain better endoscopic therapy outcomes for EGC.     

Diagnosis of different liver fibrosis characteristics by blood tests in non‐alcoholic fatty liver disease

Aims: Our aim was to develop an accurate, non‐invasive, blood‐test‐based method for identifying the main characteristics of liver fibrosis in non‐alcoholic fatty liver disease (NAFLD). Methods: Fibrosis was staged according to NASH‐CRN and Metavir systems in 226 patients with NAFLD. A fully automated algorithm measured the fractal dimension (FD) and the area of fibrosis (AOF). Independent predictors of diagnostic targets were determined using bootstrap methods. Results: (i) Development. Significant fibrosis defined by NASH‐CRN F≥2 was diagnosed by weight, glycaemia, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and prothrombin index [area under the receiver operating characteristic (AUROC)=0.867]; significant fibrosis defined by Metavir F≥2 was diagnosed by weight, age, glycaemia, AST, ALT, ferritin and platelets (FibroMeter AUROC=0.941, P<0.005). AOF was estimated by the combination of hyaluronic acid, glycaemia, AST, ALT, platelets and prothrombin index (_aR²=0.530), while FD was estimated by hyaluronic acid, glycaemia, AST/ALT, weight and platelets (_aR²=0.529). (ii) Evaluation. Although NASH‐CRN was a better system for fibrosis staging, Metavir staging was a better reference for blood test. Thus, the patient rate with predictive values≥90% by tests was 97.3% with Metavir reference vs. 66.5% with NASH‐CRN reference (P<10^?3). FibroMeter showed a significantly higher AUROC than the NAFLD fibrosis score for significant fibrosis, but not for severe fibrosis or cirrhosis, with both staging systems. Relationships between fibrosis lesions were well reflected by blood tests, e.g., the correlation between histological area and FD of fibrosis (r_s=0.971, P<10^?3) was well reflected by the relationship between respective blood tests (r_s=0.852, P<10^?3). Conclusions: Different characteristics of fibrosis in NAFLD can be diagnosed and quantified by blood tests with excellent accuracy.     

Cancer of the lung: staging, radiology, surgery

Primary lung cancer is the leading cause of cancer-related deaths in industrialized countries. Despite advances in treatment, the overall 5-year survival remains poor due to the advanced stage of disease at presentation. Smoking remains the main risk factor being responsible for around 85% of all cases. The most important distinction is that between non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Surgeons primarily deal with NSCLC (SCLC is an aggressive tumour that usually presents with systemic disease). NSCLC has a number of histological subtypes.Patient evaluation aims to establish the cell type of the tumour, determine the stage of the disease, and to determine fitness for surgery. Staging of NSCLC is based on the tumour/node/metastasis (TNM) classification. Procedures used to diagnose or stage lung cancer can include chest X-ray, chest computed tomography (CT) scan, combined positron emission tomography/CT, CT or transbronchial guided needle biopsy, and mediastinoscopy amongst others. Surgery is the only established method for ‘curing’ NSCLC. However, only a quarter of patients have resectable disease at presentation. Surgical resection can be performed using a variety of procedures including lobectomy, pneumonectomy or wedge resections. The 5-year survival of patients with stage I lung cancer following surgical resection is 51-60%.     

Ion transfer voltammetry of tryptamine,serotonin, and tryptophan at the nitrobenzene/water interface

The transfer of the cationic forms of tryptamine and serotonin across the nitrobenzene (NB)/water (W) interface was studied by cyclic voltammetry. Well-defined voltammetric waves were observed within the potential window. The standard potentials of the transfer were determined from the midpoint potentials of the voltammograms. The transfer of the cationic form of tryptophan across the NB/W interface was also observed using an acidic aqueous solution.     

婴幼儿带状疱疹6例

报告6例婴幼儿带状疱疹。男1例,女5例;年龄5个月~3岁;病程3~5 d。皮损符合带状疱疹特征,红斑、水疱呈簇集带状单侧分布,其中耳带状疱疹1例。在常规抗病毒综合治疗同时给予液氮冷喷擦拭和复方紫草油外用,疗效显著。     

肾穿刺患者术前焦虑状况护理干预

目的:探讨护理干预对肾穿刺活体组织检查术患者的焦虑状态的影响。方法:将欲行肾穿刺的患者在术前按年龄和性别随机分为实验组和对照组,应用焦虑自评量表(SAS),评定其在护理干预前后的焦虑状态,并将结果进行统计学分析。结果:肾穿刺患者术前存在着较严重的焦虑状态,进行有针对性的心理干预、认知干预和行为干预后患者的焦虑状态明显减轻,差异有统计学意义(P<0.01)。结论:肾穿刺活体组织检查患者术前存在不同程度的焦虑状态,实施有针对性的护理干预后可明显降低患者的焦虑情绪。     

Spontaneous progression of ligatured induced peri-implantitis at implants with different surface characteristics. An experimental study in dogs II: histological observations

Aim: The aim of the present study was to analyze tissue reactions to plaque formation following ligature removal in experimental peri-implantitis at commercially available implants in dogs.
Material and methods: Mandibular premolars and the three anterior premolars in both sides of the maxilla were extracted in six Labrador dogs. After 3 months, four implants representing four different implant systems – groups A (turned), B (TiOblast), C (SLA), D (TiUnite) – were placed in a randomized order in the right side of the mandible. Three months after implant installation, experimental peri-implantitis was initiated by placement of ligatures and plaque formation. The ligatures were removed when about 40–50% of the supporting bone was lost. After the subsequent 24-week period of continued plaque accumulation, block biopsies containing implants and their surrounding tissues were obtained and prepared for histological analysis.
Results: All types of implants exhibited extensive inflammatory cell infiltrates and large associated crater-formed osseous defects. The lesions were consistently characterized by insufficient encapsulation of pus and biofilm layers and the inflammatory cell infiltrates extended apical of the pocket epithelium. The presence of numerous osteoclasts indicated active tissue destruction. The vertical dimension and the overall surface area of the infiltrated connective tissue (ICT) were larger at implants of group D than at other implant types.
Conclusion: It is suggested that spontaneous progression of peri-implantitis is associated with severe inflammation and tissue destruction.