甲状腺功能亢进患者行乳晕入路腔镜下甲状腺手术的技巧探讨

目的探讨乳晕入路腔镜下甲状腺手术治疗甲状腺功能亢进的操作技巧。方法回顾性分析该院34例甲状腺功能亢进患者的病例资料,对手术情况及术中出血和腺体切除的方式进行分析。结果该组病例无中转手术,手术时间(128.9±28.6)min,术中出血量(75.3±28.4)mL,术后2例出现甲状旁腺激素(PTH)降低,术中腺体血管出血200 mL以上者6例(17.6%),腺体分块切除27例(79.4%)。结论腔镜手术治疗甲状腺功能亢进难度较大,术中要控制出血,医师需掌握操作技巧,通过一定数量病例学习曲线的练习,才可保障手术的成功。

A Case Report of Acute Arterial Embolization of Right Lower Extremity As the Initial Presentation of Nephrotic Syndrome with Minimal Changes

THROMBOEMBOLISM is a well-known complicationof nephrotic syndrome. Deep vein thrombosis,pulmonary embolism and renal vein thrombosisare the most common venous thromboembolicdiseases in patients with nephrotic syndrome, while arterialthromboembolic complications are observed less frequently,and rarely when it occurs before the diagnosis of nephroticsyndrome.1 Here we report a case with minimal change ofnephrotic syndrome who presented initially as external iliacartery thrombosis, which may be associated with longsitting while playing Mah-Jong.

Broad-band phase retrieval method for transient radial shearing interference using chirp Z transform technique

The transient radial shearing interferometry technique based on fast Fourier transform(FFT)provides a means for the measurement of the wavefront phase of transient light field.However,which factors affect the spatial bandwidth of the wavefront phase measurement of this technology and how to achieve high-precision measurement of the broad-band transient wavefront phase are problems that need to be studied further.To this end,a theoretical model of phase-retrieved bandwidth of radial shearing interferometry is established in this paper.The influence of the spatial carrier frequency and the calculation window on phase-retrieved bandwidth is analyzed,and the optimal carrier frequency and calculation window are obtained.On this basis,a broad-band transient radial shearing interference phase-retrieval method based on chirp Z transform(CZT)is proposed,and the corresponding algorithm is given.Through theoretical simulation,a known phase is used to generate the interferogram and it is retrieved by the traditional method and the proposed method respectively.The residual wavefront RMS of the traditional method is 0.146λ,and it is 0.037λfor the proposed method,which manifests an improvement of accuracy by an order of magnitude.At the same time,different levels of signal-to-noise ratios(SNRs)from 50 dB to 10 dB of the interferogram are simulated,and the RMS of the residual wavefront is from 0.040λto 0.066λ.In terms of experiments,an experimental verification device based on a phase-only spatial light modulator is built,and the known phase on the modulator is retrieved from the actual interferogram.The RMS of the residual wavefront retrieved through FFT is 0.112λ,and it decreases to 0.035λthrough CZT.The experimental results verify the effectiveness of the method proposed in this paper.Furthermore,the method can be used in other types of spatial carrier frequency interference,such as lateral shearing interference,rotational shearing interference,flipping shearing interference,and four-wave shearing interference.

Modified scaling angular spectrum method for numerical simulation in long-distance propagation

The angular method(AS)cannot be used in long-distance propagation because it produces severe numerical errors due to the sampling problem in the transfer function.Two ways can solve this problem in AS for long-distance propagation.One is zero-padding to make sure that the calculation window is wide enough,but it leads to a huge calculation burden.The other is a method called band-limited angular spectrum(BLAS),in which the transfer function is truncated and results in that the calculation accuracy decreases as the propagation distance increases.In this paper,a new method called modified scaling angular spectrum(MSAS)to solve the problem for long-distance propagation is proposed.A scaling factor is introduced in MSAS so that the sampling interval of the input plane can be adjusted arbitrarily unlike AS whose sampling interval is restricted by the detector’s pixel size.The sampling interval of the input plane is larger than the detector’s pixel size so the size of calculation window suitable for long-distance field propagation in the input plane is smaller than the size of the calculation window required by the zero-padding.Therefore,the method reduces the calculation redundancy and improves the calculation speed.The results from simulations and experiments show that MSAS has a good signal-to-noise ratio(SNR),and the calculation accuracy of MSAS is better than BLAS.

Application of contrast agent injection device in real-time threedimensional hysterosalpingo-contrast sonography

Objective:To investigate the correlation between the peak pressure of contrast agent injection and tubal patency during real-time three-dimensional hysterosalpingo-contrast sonography.Methods:Seventy female patients who underwent real-time three-dimensional hysterosalpingo-contrast sonography of uterine and oviduct in the department of ultrasound medicine in our hospital were selected to measure the peak pressure in the examination process through the pressure injection device of contrast agent,to compare the pressure differences of different obturability patency degree of oviduct,and to draw a ROC curve to determine the optimal cut-off value of the peak pressure.Results:According to the different patency degree of fallopian tubes,the contrast results were divided into three groups:bilateral tubes unobstructed group,unilateral tube lesioned group and bilateral tubes lesioned group.The peak pressures of the three groups were(34.69±9.30)KPa,(52.71±18.55)KPa and(73.88±11.01)KPa,respectively.The area under the peak pressure ROC curve(AUC)of the"unilateral tube lesioned group"and"bilateral tubes lesioned group"was 0.785,the optimal cut-off value of the peak pressure was 51.90KPa,the area under the peak pressure ROC curve(AUC)of the"unilateral tube lesioned group"and"bilateral tubes lesioned group"was 0.851,and the optimal cut-off value of the peak pressure was 73.50KPa.Conclusion:The peak pressure of contrast agent injection in RT-3D-HyCoSy can be used as a quantitative index to deduce the patency degree of oviduct.There is a correlation between the peak pressure and the tubal patency.

Assessment of Serum Vitamin D Levels in Children With Pityriasis Alba:A Retrospective Study

Objective:This study was performed to analyze the correlation between pityriasis alba(PA)and the serum 25-hydroxyvitamin D status in children.Methods:The study population comprised 460 patients with PA and 254 age-and sex-matched healthy controls.The serum level of 25-hydroxyvitamin D was compared between the two groups by studentt test.Results:The serum level of 25-hydroxyvitamin D was significantly lower in patients with PA than in healthy controls(P<0.001).There were statistically significant differences in the serum vitamin D status between the PA group and control group(P<0.001);specifically,patients with PA had a significantly higher frequency of vitamin D deficiency(52.83%vs.24.35%,P=0.001)and lower frequency of vitamin D sufficiency(22.83%vs.37.01%,P<0.001)than controls.PA patients showed significantly lower serum level of vitamin D than controls in deficient and sufficient groups(P=0.005 and 0.027,respectively),and in insufficient group,serum vitamin D level was lower in PA patients than in controls,but it showed no statistical difference(P=0.061).Conclusion:Vitamin D may play a role in the pathogenesis of PA.Further investigations are required to establish the relationship between the severity of PA and the vitamin D status and to evaluate the potential for use of vitamin D in the treatment of PA.