目的：評價宮腔聲學造影(SHG)對子宮內膜息肉的診斷價值。方法：對臨床擬診宮內膜息肉的76例患者進行TVS、SHG及宮腔鏡手術病理檢查，并對結果進行分析。結果：以手術病理結果作為診斷金標準，內膜息肉48例，黏膜下肌瘤9例，內膜增生10例，宮腔內機化血凝塊3例，正常內膜6例。SHG對子宮內膜息肉診斷的準確性為93.4%，敏感性為93.7%，特異性為92.8%。TVS對子宮內膜息肉診斷的準確性為59.2%，敏感性為81.2%，特異性為21.4%。兩種方法對內膜息肉的診斷準確率比較有顯著差異(χ2=5.45，P=0.019)。結論：宮腔聲學造影準確率高，是診斷子宮內膜息肉的可靠方法。
【摘要】 目的 探討嬰幼兒常見泌尿系統先天發育異常的超聲特征。 方法 回顧性分析2008年9月17日-2010年6月1日體檢的嬰幼兒中所發現的各種泌尿系統先天性發育異常的超聲表現。 結果 發現泌尿系統先天性發育異常88例，其中腎缺如50例，多房性腎囊性變10例，多囊腎2例，腎旋轉不良1例，重復腎10例，輸尿管囊腫6例，異位腎7例，融合腎2例。 結論 嬰幼兒常見的泌尿系統先天性發育異常有較特異的超聲表現，超聲檢查是篩查嬰幼兒泌尿系統先天性發育異常的首選影像學檢查方法。【Abstract】 Objective To study the ultrasonic characteristics of congenital malformation of infantile urinary system. Methods We analyzed various ultrasonic appearances of congenital malformation of infantile urinary system in our hospital in the recent two years retrospectively. Result We found 88 cases of congenital urinary system malformation in all infants, including 50 cases of renal agenesis, 10 cases of multi-cystic kidney, 2 cases of policystic kidney, 1 case of malrotation of kidney, 10 cases of duplex kidney, 6 cases of ureter cyst, 7 cases of ectopic kidney, and 2 cases of fused kidney. Conclusion Special ultrasonic appearances can be detected for congenital malformation of infantile urinary system, so ultrasound can be regarded as the first-line iconographical examination for the disease.
ObjectiveTo investigate the relationship between nonalcoholic fatty liver disease (NAFLD) and Helicobacter pylori (HP) infection. MethodsMedical examination data of healthy physical examination participates who underwent carbon 14 urea breath test for detection of HP and abdominal ultrasound examination between March and June 2015 were analyzed. Cross sectional analysis was carried out. Based on the diagnostic criteria of NAFLD, the subjects were divided into two groups: NAFLD group and normal control group. HP infection was compared between the two groups. Logistics regression analysis was performed to analyze the relationship between HP infection and NAFLD. ResultsThe proportion of men, age, weight, body mass index (BMI), waistline, alanine aminotransferase (ALT), aspartate aminotransferase, glutamyl transferase, albumin, fasting blood-glucose (GLU), total cholesterol triacylglycerol (TG), low density lipoprotein-cholesterol, and blood pressure were all significantly higher in the NAFLD group than the control group (P < 0.05), while height and high density lipoprotein-cholesterol were significantly lower in the NAFLD group (P < 0.05). The detection rate of NAFLD in males was higher than that in females. The detection rates of NAFLD in different age groups were significantly different, and the highest detection rate of NAFLD was in the age group of 50-59 years old (P < 0.05). The rate of HP infection was not significantly different in subjects of different ages and genders (P > 0.05). The rate of HP infection in the NAFLD group was significantly higher than those of the control group in age groups of 18-29, 30-39, 40-49, 50-59, and 70-79 years old (P < 0.05). The logistic regression analysis revealed that age, HP infection, TG, ALT, BMI, GLU, and diastolic pressure were correlated with NAFLD (P < 0.05). ConclusionHP infection may be a risk factor in the development of NAFLD.
ObjectiveTo detect the expression of human transforming growth factor β1 (hTGF-β1) gene mediated by adenovirus (Ad) in hamstring tendon after anterior cruciate ligament (ACL) reconstruction in rabbits. MethodsAd-hTGF-β1 and Ad-green fluorescent protein (GFP) were diluted to 5×108 PFU/mL with DMEM. Forty-eight New Zealand white rabbits were divided into 3 groups randomly (n=16) for ACL reconstruction with hamstring tendon autograft. Hamstring tendon was cultured and transfected with Ad-hTGF-β1 (group A) and Ad-GFP (group B) for 12 hours before ACL reconstruction, and was cultured with DMEM in group C. After 12 hours of transfection, green fluorescence was observed in groups A and B under fluorescence microscopy. At 2, 4, 6, and 8 weeks after operation, the hamstring tendon was harvested to detect the mRNA and protein expressions of hTGF-β1 by real time fluorescence quantitative PCR and Western blot. ResultsGreen fluorescence was observed after 12 hours of transfection in groups A and B. TGF-β1 protein level reached (221.0±12.2) ng/mL at 12 hours in group A. The hTGF-β1 mRNA expression could be detected in group A, but it could not be detected in group B and group C. The mRNA expression levels of hTGF-β1 were 1.004±0.072 at 2 weeks, 0.785±0.038 at 4 weeks, 0.469±0.053 at 6 weeks, and 0.172±0.021 at 8 weeks in group A, showing significant difference (P<0.05). Western blot results showed weakly positive band in groups B and C; the protein expression of TGF-β1 in group A was significantly higher than that in groups B and C (P<0.05), but no significant difference was found between groups B and C P>0.05). The protein expression of TGF-β1 gradually reduced with time, showing significant difference between different time points (P<0.05). ConclusionAd-hTGF-β1 can transfect the hamstring tendon successfully, and it can effectively express for a long time after ACL reconstruction.
Objective To explore the oxygen therapy effects of high-flow T-tube oxygen therapy on neurointensive care patients who have undergone tracheostomy and are undergoing mechanical ventilation while meeting the criteria for weaning from mechanical ventilation, especially in terms of controlling airway temperature and humidity, promoting mucus dilution, and reducing postoperative complications. MethodsCollected data from 50 neurointensive care patients who underwent tracheostomy and were on mechanical ventilation, meeting the criteria for weaning from mechanical ventilation, treated at West China Hospital of Sichuan University from September 2019 to September 2021. The three groups of patients had different weaning methods: a high-flow T-tube for weaning, a heat and moisture exchanger (artificial nose) for weaning, and a high-flow tracheal joint for weaning. The vital signs, dyspnea and blood gas analysis before and three days after weaning were collected. The primary outcomes were mechanical sputum excretion, postural drainage, phlegm-resolving drugs use, airway-related events (artificial airway blockage, artificial nose blockage, lung infection), stay in ICU (days), and death in ICU. Results Among the 50 patients, 28 were males and 22 were females. There were no significant differences in age, weight, height, gender, finger pulse oxygen saturation, heart rate, APACHEII score, sequential organ failure assessment, or Glasgow coma scale among the three groups (P>0.05). There was no statistical difference in the number of 72-hour mechanical sputum excretion or the use of phlegm-resolving drugs in the three groups (P=0.113, P=1.00). Conclusion The use of high-flow T-tube oxygen therapy in neurointensive care patients who have undergone tracheostomy, are on mechanical ventilation, and meet the criteria for weaning from mechanical ventilation can effectively control airway temperature and humidity, promote mucus dilution for better drainage, thereby reducing post-tracheostomy complications.
Liver transplantation is currently the only effective curative treatment for end-stage liver disease. In recent years, with advancements in liver transplantation surgery and anti-rejection drugs, the incidence of surgical complications and organ rejection has gradually decreased. Conversely, transplant-related infections have increasingly become a major factor affecting the prognosis of transplant recipients. Furthermore, due to the progress in critical life support technologies, the time spent in the donor’s intensive care unit (ICU) has been extended, and post-transplant infections originating from the donor, especially donor-derived infection (DDI), have become one of the primary sources of infection for recipients. Studies have shown that infections in liver transplant recipients are often caused by Gram-negative pathogens, particularly carbapenem-resistant Klebsiella pneumoniae (CRKP), which has now become the leading cause of fatal infections in liver transplant recipients. To reduce the risk of donor-derived infections, it is necessary to strengthen donor screening and evaluation, establish standardized testing processes, and adjust the use strategies of post-transplant anti-infective drugs and immunosuppressants. Monitoring the immune status of recipients is also crucial. Multidisciplinary collaboration and the application of new technologies will be key in future infection prevention and control. To promote the prevention and treatment of CRKP-related donor infections, West China Hospital of Sichuan University, in collaboration with international experiences, has organized relevant experts to develop an expert consensus on the prevention and treatment of CRKP-targeted DDI.