Objective To study the MRI characteristics of aspergillus disease in the paranasal sinuses.Methods 25 cases of aspergillus disease in the paranasal sinuses proved by operation and pathology were analyzed retrospectively.Results (1) 25 patients were verified by operation and pathology, including maxillary sinus(n=20),nasal cavity and maxillary sinus and ethmoidali sinus(n=4), sphenoidallis sinus(n=1).(2)MRI specific sign included: T 1-weighted was indicated by 6 cases of medium signals, 10 cases of higher signal, 4 cases of high signal. T 2-weighted was all indicated by the change of low or lowest signal.Conclusion Calcification with hyperintensity on T 1-weighted MRI imaging is special MRI characteristics of aspergillus disease in the paranasal sinuses,it is of significance for the correct diagnosis and differential diagnosis.
To develop and validate a simple-to-use nomogram for prediction of 3-/5-year survival in patients with N0M0 hepatocellular carcinoma after curative liver resection. Patients and Methods. Patients diagnosed HCC with hepatic resection in the Surveillance, Epidemiology, and End Results (SEER) database were included to identify prognostic factors of overall survival. Multivariate Cox regression were used to create a nomogram.We identified 4856 HCC with hepatic resection from the SEER database. A nomogram to predict long-term survival with a C-index 0.667 (95% CI, 0.653 to 0.681) is more efficient than TNM staging with a lower C-index 0.613 (95% CI, 0.597 to 0.629). The C-index was confirmed to be 0.663 (95% CI, 0.640 to 0.686) through validation, suggesting a good discrimination and a good prediction capability.The nomogram is a simple and effective screening tool for assessing the prognosis of HCC with hepatic resection and assists with the planning of individual postoperative surveillance protocols.
There is an urgent need for non-invasive methods for predicting portal hypertensive gastropathy (PHG). This study aims to develop and validate a non-invasive method based on clinical parameters for predicting PHG in patients with liver cirrhosis (LC).The overall survival (OS) and hepatocellular carcinoma (HCC)-free survival were evaluated in LC patients, both with and without PHG. A prediction model for PHG was then constructed based on a training dataset that contained data on 492 LC patients. The discrimination, calibration, and clinical utility of the predicting nomogram were assessed using the C-index, calibration plot, and decision curve analysis. Internal validation was conducted using a bootstrapping method, and further external validation using data on the 208 other patients.LC patients with PHG had a worse prognosis compared with those without PHG. A nomogram was constructed using clinical parameters, such as age, hemoglobin content, platelet count and Child-Pugh class. The C-index was 0.773 (95% CI: 0.730-0.816) in the training cohort, 0.761 after bootstrapping and 0.745 (95% CI: 0.673-0.817) in the validation cohort. The AUC values were 0.767, 0.724, and 0.756 in the training, validation and total cohorts, respectively. Well-fitted calibration curves were observed in the training and validation cohorts. Decision curve analysis demonstrated that the nomogram was clinically useful at a threshold of 15%.The nomogram constructed to predict the risk of developing PHG was found to be clinically viable. Furthermore, PHG is an independent risk factor for OS of LC, but not for the occurrence of HCC.
Background Primary intracranial teratomas are rare intracranial neoplasms, and are subdivided into mature, immature, and those with malignant transformation. To date, only a few studies of teratoma imaging have been reported. Purpose To describe and characterize the magnetic resonance imaging (MRI) findings in a series of 18 patients (16 men/boys and 2 women/girls; mean age, 14.5 years) with pathologically proven teratomas. Material and Methods Findings from medical records and imaging examinations in 18 patients with pathologically confirmed intracranial teratomas from 2001 to 2011were retrospectively reviewed at our two institutions. Two radiologists evaluated the lesion location, shape, size, number, edge, homogeneous or heterogeneous appearance, attenuation, signal intensity, and degree of enhancement. Results All tumors were located within the pineal ( n = 13), parasellar ( n = 2), or suprasellar ( n = 3) regions. The lesions appeared of mixed intensity on MRI, reflecting the histologic heterogeneity, including fibrosis, fatty tissue, calcification, cysts, and keratinocytes. In mature teratomas ( n = 9), seven of nine tumors showed non-enhanced multilocularity or heterogeneous enhancement of the cyst wall on contrast-enhanced T1-weighted (T1W) images. Two of nine tumors showed moderate, heterogeneous enhancement in the solid portion of the lesion; whereas in immature ( n = 7) or malignant transformation ( n = 2) teratomas, heterogeneous, ring-like, intratumoral patchy enhancement was noted on T1W images with contrast. Conclusion Primary intracranial teratomas are usually localized in the pineal and the suprasellar regions, and often present an ovoid or lobulated mass with or without multilocularity on MRI. Marked enhancement of the solid portion or the thick wall of the tumor was the key feature for distinguishing mature teratoma and malignant teratoma.
Skin ulcer is a common type of disease affecting patients' health and quality of life, and bacterial infection increases the difficulty of its management.The present study collected the results of bacterial culture sampled from the surface of 110 cases of skin ulcers at our hospital from January 2011 to December 2012. We analyzed the constituent ratios of ulcer surface bacteria, the change in the main infectious bacteria and the results of drug-sensitivity testing for common bacteria. In addition, the characteristics of bacterial infection of skin ulcers were summarized.Of the 110 samples, 90 isolated bacteria were cultured. Sixty-one were Gram-negative bacteria, mainly comprising Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli. In addition, 23 isolates were Gram-positive bacteria, mainly comprising Staphylococcus aureus and Enterococcus faecalis. The probability of a negative bacterial culture in 2012 was significantly lower than that in 2011 (16.7% vs. 40.0%, p < 0.01). Moreover, the probability of P. aeruginosa infection in 2012 was significantly higher than that in 2011 (31.7% vs. 14.0%, p < 0.01). P. aeruginosa was resistant to seven commonly used antibiotics. Both K. pneumoniae and E. coli had higher resistance to ampicillin. E. cloacae were not sensitive to piperacillin/tazobactam. Acinetobacter baumannii was resistant to all the tested drugs. S. aureus, E. faecalis and Staphylococcus epidermidis had high resistance to clindamycin. There was other drug resistance to reflect the higher rate of skin bacterial resistance.Skin bacterial resistance rate is high. Gram-negative bacteria gradually account for the majority, and P. aeruginosa becomes the most important skin infection pathogen. These characteristics of bacterial infections of skin ulcers provide a significant reference for guiding the selection of antibiotics, better controlling infections of skin ulcers and accelerating the healing of skin ulcers.
Abstract An ecofriendly and green procedure was adopted to immobilize Ag NPs over acacia gum (GA)-modified magnetic nanoparticles (Fe 3 O 4 -GA/Ag NPs) with analgesic and anesthetic properties. In the stepwise modification method, the pre-synthesized Fe 3 O 4 NPs were coated by the gum acacia (GA) that has hydroxyl groups on its backbone and can be used for as a capping, reducing, and stabilizing agent for immobilized Ag nanoparticles. The capped Ag ions were reduced and immobilized over the acacia gum because of hydrogen bonding of the hydroxyl groups. The final bio-material was characterized by various analytical techniques such as X-ray diffraction, energy dispersive X-ray spectroscopy, inductively coupled plasma-optical emission microscope, transmission electron microscopy, field emission scanning electron microscopy, and fourier transformed infra red spectroscopy. In the in vivo design, the results of anesthetic activity indicated that the Fe 3 O 4 -GA/Ag NPs made local anesthetic effects in guinea pig and frog models. After oral administration of Fe 3 O 4 -GA/Ag NPs, paw edema was significantly decreased in mice. Acetic acid-induced writhing episodes were dose-dependently and significantly decreased in all groups treated with Fe 3 O 4 -GA/Ag NPs. In addition, the analgesic and anti-inflammatory properties were determined in several doses of Fe 3 O 4 -GA/Ag NPs. The above results protect the analgesic and anesthetic properties of silver nanoparticles supported over biodegradable acacia gum-modified magnetic nanoparticles for the next research or clinical trial studies in human.
Objective To explore the value of dynamic enhanced multi-layer CT scan in solitary pulmonary nodule.Methods 60 patients with signle solitary pulmonary nodules were chosen to give dynamic ehchanced multi-layer spiral CT scan.The change of CT value and the pathological results were analyzed.Results The CT values of enhanced scan were obviously higher in the malignant group than the benign group with statistical significance(P 0.05).The change of CT value equal or more than 20HU was considered to have malignant nodules,and the change less than 20HU diagnosed as benign nodules.There was no significant difference of diagnosis resluts between enhanced CT scan and pathological diagnosis on solitary nodule(χ2 = 1.40,P 0.05).Conclusion Mult-layer spiral enhanced CT scan has a high application value in the differential diagnosis of patients with benign or malignant nodules.
Objective: To analyze the clinical characteristics of early organ injury in elderly patients with severe burns and the effects on the prognosis of patients. Methods: From January 2010 to August 2018, 62 patients with severe burns (43 men and 19 women, aged from 60 to 89 years at the time of admission) who were hospitalized in the Institute of Burn Research of the First Affiliated Hospital of Army Medical University (the Third Military Medical University, hereinafter referred to as the author's affiliation), meeting the inclusion criteria, were included in elderly (E) group, and 124 patients with severe burns (86 men and 38 women, aged from 18 to 59 years at the time of admission) at the same term were included in young and middle-aged (YM) group. Treatment of patients in the 2 groups followed the conventional procedures of the author's affiliation. The following data of patients in the 2 groups were retrospectively analyzed. (1) Fluid replacement volume and urine volume within the first and second post injury hour (PIH) 24 were recorded. The levels of hemoglobin, haematocrit, and blood lactic acid at admission, PIH 24 and 48 were recorded. (2) The creatine kinase isozyme-MB (CK-MB), total bilirubin, blood creatinine, oxygenation index, and blood platelet count at admission, at shock stage, and on post injury day (PID) 3 to 7 were collected. (3) The days of seriously or critically ill and deaths were recorded. Data were processed with chi-square test, group t test, Mann-Whitney U test, analysis of variance for repeated measurement, and Bonferroni correction. Results: (1) There were no statistically significant differences in fluid replacement volume within the first and second PIH 24, and urine volume within the second PIH 24 between patients in the 2 groups (t=0.351, 1.307, 1.110, P>0.05). The urine volume of patients in group E within the first PIH 24 was significantly less than that in group YM (t=5.628, P<0.05). There were no statistically significant differences in levels of hemoglobin (t=0.011, 1.075, 0.239), haematocrit (t=0, 0.033, 0.199), and blood lactic acid (t=0.017, 1.002, 0.739) at admission, PIH 24 and 48 between patients in the 2 groups (P>0.05). (2) There were no statistically significant differences in levels of CK-MB at admission and on PID 3 to 7 between patients in the 2 groups (t=0.069, 0.001, P>0.05). The level of CK-MB of patients in group E at shock stage was significantly higher than that in group YM (t=4.017, P<0.05). There were no statistically significant differences in levels of total bilirubin at admission and on PID 3 to 7 between patients in the 2 groups (t=0.227, 0.002, P>0.05). However, the level of total bilirubin of patients in group E at shock stage was significantly higher than that in group YM (t=6.485, P<0.05). The levels of blood creatinine of patients in group E at admission and shock stage were significantly higher than those in group YM (t=4.226, 12.299, P<0.05 or P<0.01), while there was no statistically significant difference between them on PID 3 to 7 (t=0.693, P>0.05). The oxygenation indexes of patients in group E at admission and shock stage and on PID 3 to 7 [(371±16), (263±16), and (228±18) mmHg (1 mmHg=0.133 kPa)] were lower than (420±13), (327±13), and (281±17) mmHg of patients in group YM, respectively (t=5.650, 9.782, 4.856, P<0.05 or P<0.01). There were no statistically significant differences in levels of blood platelet count at admission and shock stage between patients in the 2 groups (t=0.038, 0.588, P>0.05), while the level of blood platelet count of patients in group E on PID 3 to 7 was significantly lower than that in group YM (t=6.636, P<0.05). (3) The days of seriously or critically ill and death rate of patients in group E were respectively longer or higher than those in group YM (Z=-2.303, χ(2)=13.676, P<0.05 or P<0.01). Conclusions: In the case of the same tissue perfusion at shock stage, injuries in heart, liver, kidney, lung, and coagulation system in elderly patients with severe burns are more obvious than those in young and middle-aged patients, with more severe illness and higher mortality.目的： 分析老年严重烧伤患者早期脏器损伤的临床特点及其对预后的影响。 方法： 将陆军军医大学(第三军医大学)第一附属医院全军烧伤研究所(以下称笔者单位)2010年1月—2018年8月收治的符合入选标准的62例入院时年龄≥60岁的严重烧伤患者(男43例、女19例，年龄60～89岁)纳入老年组，将同期124例入院时年龄在18～59岁的严重烧伤患者(男86例、女38例，年龄18～59岁)纳入中青年组。2组患者入院后均按笔者单位常规治疗方案治疗。回顾性分析2组患者如下指标。(1)伤后第1、2个24 h的补液量和尿量，入院时及伤后24、48 h的血红蛋白、血细胞比容、血乳酸水平。(2)入院时、休克期、伤后3～7 d的心肌型肌酸激酶同工酶(CK－MB)、总胆红素、血肌酐、氧合指数、血小板计数。(3)病重病危天数及死亡情况。对数据行χ(2)检验、成组t检验、Mann－Whitney U检验、重复测量方差分析及Bonferroni校正。 结果： (1)2组患者伤后第1、2个24 h补液量及伤后第2个24 h尿量比较，差异无统计学意义(t＝0.351、1.307，1.110，P>0.05)；老年组患者伤后第1个24 h尿量明显少于中青年组(t＝5.628，P<0.05)。2组患者入院时及伤后24、48 h血红蛋白(t＝0.011、1.075、0.239)、血细胞比容(t＝0、0.033、0.199)及血乳酸水平(t＝0.017、1.002、0.739)比较，差异无统计学意义(P>0.05)。(2)2组患者入院时及伤后3～7 d CK－MB水平比较，差异无统计学意义(t＝0.069、0.001，P>0.05)；老年组患者休克期CK－MB水平明显高于中青年组(t＝4.017，P<0.05)。2组患者入院时及伤后3～7 d总胆红素水平比较，差异无统计学意义(t＝0.227、0.002，P>0.05)；老年组患者休克期总胆红素水平明显高于中青年组(t＝6.485，P<0.05)。老年组患者入院时及休克期血肌酐水平明显高于中青年组(t＝4.226、12.299，P<0.05或P<0.01)；2组患者伤后3～7 d血肌酐水平比较，差异无统计学意义(t＝0.693，P>0.05)。老年组患者入院时、休克期及伤后3～7 d氧合指数分别为(371±16)、(263±16)、(228±18)mmHg(1 mmHg＝0.133 kPa)，明显低于中青年组的(420±13)、(327±13)、(281±17)mmHg(t＝5.650、9.782、4.856，P<0.05或P<0.01)。2组患者入院时及休克期血小板计数比较，差异无统计学意义(t＝0.038、0.588，P>0.05)；老年组患者伤后3～7 d血小板计数明显低于中青年组(t＝6.636，P<0.05)。(3)老年组患者的病重病危天数、病死率分别长于、高于中青年组(Z＝－2.303，χ(2)＝13.676，P<0.05或P<0.01)。 结论： 与中青年严重烧伤患者相比，在休克期同等组织灌注的情况下，老年严重烧伤患者早期心脏、肝脏、肾脏、肺脏、凝血系统损伤明显，病情重且病死率高。.
Objective To evaluate the results of primary repair of nail bed defect of the fingers using split nail bed grafting from the big toe. Methods From August 2005 to August 2008, traumatic nail bed defects of the fingers in 12 cases \14 fingers were treated with split nail bed grafting from the big toe. Results All patients were follow-up for 3 to 10 months, with an average of 8 months. All grafts in the 12 patients 14 fingers survived. Twelve nail beds grew with satisfactory appearance. Two nail beds were uneven due to postoperative infection and distal phalanx fracture. The overall appearance and function of the repaired fingers and the donor toes were good. Conclusion Split nail bed grafting from the toe is a promising method for repair of nail bed defects. The surgical procedure is easy and leads to satisfactory appearance and function of the fingers.
Key words:
Nails ; Finger injuries ; Transplantation ;
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