Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children

BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic procedures.Gastroscopy is the gold standard for the diagnosis of peptic ulcer,but it is an invasive procedure.Gastrointestinal contrast-enhanced ultrasonography(CEUS)has the advantages of being painless,noninvasive,nonradioactive,easy to use,and safe.AIM To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children.METHODS We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022.All children were examined by routine ultrasound,gastrointestinal CEUS,and gastroscopy.The pathological results of gastroscopy were taken as the gold standard.Routine ultrasonography was performed before gastrointestinal CEUS.Conventional ultrasound showed the thickness of the gastroduodenal wall,gastric peristalsis,and the adjacent organs and tissues around the abdominal cavity.Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall;the size,location and shape of the ulcer;gastric peristalsis;and adjacent organs and tissues around the abdominal cavity.The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS.All children received informed consent from their guardians for CEUS.This study was reviewed and approved by the hospital medical ethics committee.RESULTS Among the 43 children,17(15 male,2 female)were diagnosed with peptic ulcer by gastroscopy.There were 26 children with nonpeptic ulcer.There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound.The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1%(34/43),which was significantly different from that of gastroscopy(P=0.033).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low.Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS.The diagnostic coincidence rate of peptic ulcer in children was 95.3%(41/43).There was no significant difference between CEUS and gastroscopy(P=0.655).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high.CONCLUSION Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children,and can be used as a preliminary examination method.

Primary hepatic epithelioid angiomyolipoma: A malignant potential tumor which should be recognized

AIM: To improve the clinical diagnosis and recognition of hepatic epithelioid angiomyolipoma(HEAML).METHODS: Four cases of primary HEAML were confirmed based on the pathology archive system in our hospital from January 2009 to November 2015. The general state, clinical symptoms, imaging manifestations, histological results and immunohistochemistry of these patients were retrospectively reviewed and analyzed. Studies of HEAML published in the last 15 years were collected from Pub Med and MEDLINE to summarize the clinical symptoms, imaging characteristics, pathological features and management of HEAML.RESULTS: Four cases of primary HEAML were retrieved from our archives. These included three female patients and one male patient, with a mean age of 41.8 ± 11.5 years(ranging from 31 to 56 years). The meantumor size was 7.3 ± 5.5 cm(ranging from 3.0 to 15 cm). In the contrast-enhanced imaging, the tumor was obviously enhanced in the arterial phase, but enhanced continuously or exhibited a slow-density masse during the venous and delayed phases. Histologically, the tumors mainly consisted of epithelioid cells that comprised approximately 95% of the total neoplastic mass. Although no metastases occurred in our patients, pathological studies revealed necrosis, mitotic figures and liver invasion in two patients, which indicates aggressive behavior. Immunohistochemical staining revealed that human melanoma black 45(HMB-45) and Melan-A were positive in 4 cases. We only identified 81 cases with primary HEAML, including our present patients, from 26 articles available from Pub Med and MEDLINE. The majority of the papers were published as case reports. Only 5(5/75, 6%) cases were associated with tuberous sclerosis complex(TSC). More than half(35/66) were discovered incidentally upon physical examination. Approximately 65%(22/34) of the patients were misdiagnosed with HCC or other tumors before surgery. Approximately 10%(8/81) of the patients with HEAML had recurrence or metastasis after surgery, which was a very high and alarming rate.CONCLUSION: HEAML is a very rare primary hepatic tumor that is often misdiagnosed before surgery. Patients should be followed closely after surgery because of its malignant potential.

Pancreatic cancer: open or minimally invasive surgery?

Pancreatic duct adenocarcinoma is one of the most fatal malignancies, with R0 resection remaining the most important part of treatment of this malignancy. However, pancreatectomy is believed to be one of the most challenging procedures and R0 resection remains the only chance for patients with pancreatic cancer to have a good prognosis. Some surgeons have tried minimally invasive pancreatic surgery, but the shortand long-term outcomes of pancreatic malignancy remain controversial between open and minimally invasive procedures. We collected comparative data about minimally invasive and open pancreatic surgery. The available evidence suggests that minimally invasive pancreaticoduodenectomy(MIPD) is as safe and feasible as open PD(OPD), and shows some benefit, such as less intraoperative blood loss and shorter postoperative hospital stay. Despite the limited evidence for MIPD in pancreatic cancer, most of the available data show that the short-term oncological adequacy is similar between MIPD and OPD. Some surgical techniques, including superior mesenteric artery-first approach and laparoscopic pancreatoduodenectomy with major vein resection, are believed to improve the rate of R0 resection. Laparoscopic distal pancreatectomy is less technically demanding and is accepted in more pancreatic centers. It is technically safe and feasible and has similar short-term oncological prognosis compared with open distal pancreatectomy.

Low color temperature artificial lighting can slow myopia development: Long-term study using juvenile monkeys

The incidence of myopia has increased rapidly in recent decades, suggesting that environmental factors, such as light,may be an important cause. Correlated color temperature(CCT) is a commonly used index to quantify the spectral composition of light. Here, we used 32 juvenile monkeys(16 females and 16 males) and selected four kinds of light with typical but different CCTs to study the relationship between CCT and ocular axial elongation.

Laparoscope resection of retroperitoneal ectopic insulinoma: A rare case

Ectopic insulinoma is a very rare and dormant tumor.Here we report the case of a 79-year-old female who presented with repeated episodes of hypoglycemia and was diagnosed with insulinoma based on laboratory and imaging examinations.Computed tomography and positron emission tomography revealed a tumor in the retroperitoneum under and left of the hepatoduodenal ligament, which was resected successfully using a laparoscopic approach.Pathologic results revealed an ectopic insulinoma, which was confirmed immunohistochemically.Ectopic insulinomas are accompanied by hypoglycemia that can be misdiagnosed as drug- or disease-induced.These tumors are difficult to diagnose and locate, particularly in atypical cases or for very small tumors.Synthetic or targeted examinations, including low blood glucose, elevated insulin, proinsulin, and C-peptide levels, 48-h fasting tests, and relevant imaging methods should be considered for suspected cases of insulinoma.Surgery is the treatment of choice for patients with insulinoma, and laparoscopic resection is a feasible and effective method for select ectopic insulinoma cases.

Is laparoscopic radical cholecystectomy an effective and safe approach for advanced gallbladder cancer?

Although laparoscopy has been widely used in the surgical field and is even considered the first-line to diagnose various diseases,laparoscopic radical cholecystectomy(LRC)for gallbladder cancer(GBC)has always been relatively contraindicated.Inadequate lymphadenectomy,complicated liver resection,specific biological behavior of GBC cells,and chimney and aerosol effects from the pneumoperitoneum are the previously misunderstood areas in laparoscopic surgery[1].Initially,laparoscopic approach was used for intra-abdominal GBC exploration to determine the presence of peritoneal metastasis,intraoperative staging,and palliative treatment.With the advancement of laparoscopic surgery,laparoscopic liver resection,laparoscopic pancreaticoduodenectomy,and laparoscopic radical gastrectomy have been routinely performed in several medical centers.Kim et al.[2]recently demonstrated that laparoscopic technique is feasible for GBC.However,the feasibility of LRC depends on the following factors.

A brief statistical analysis of stomatology papers published in international journals by researchers from the mainland of China-Based on Thomson Reuters’ Journal Citation Reports for 2009

This paper has briefly analyzed the publication status of Chinese stomatology papers in 2009 with statistics from Journal Citation Reports provided by Thomson Scientific. Only those papers with the first author coming from the mainland of China were included for calculations. We have found a significant increase in the number of SCIE-indexed papers, most of which were published by six dental institutions in China. Among all Chinese medical institutions, West China School of Stomatology Sichuan University is the first dental institution to enter the top-20 list with the most publications, and it also ranks the 9th in the number of outstanding articles. West China School of Stomatology Sichuan University and the Forth Military Medical University are the only two dental institutions in China which have published SCIE-indexed papers over a hundred. The former has published the most SCIE-indexed stomatology papers, while the latter has the highest average impact factor. As the laboratories and funds in China have close connections with various dental hospitals, the pratice of translational medicine in dentistry is fast and fluent.

The efficacy of TKIs in treatment of human primary small cell lung cancer xenograft model in vivo

Objective: To study the treatmaient of non-small cell lung cancer, we established the HU-Prim allograft transplantation tumor model. Methods: The fresh tumor samples were transplanted in the right scapular subcutaneous layer of the severe combined immunodeficient Non-obese diabetic/severe combined immunodeficient(NOD/SCID) mice. The pathological features of the tumors were observed. Nonnecrotic tissue was inoculated subcutaneously into the right axillary. When the tumor in burdened rat grew approximately 100 mm3, according to the tumor size all the animals were divided into the following four groups, eight rats in each group: solvent control group, gefitinib group(100 mg/kg), erlotinib group(50 mg/kg), afatinib group(20 mg/kg). Aniamals were treated with drugs by intragastric(i.g.) administrated, once daily, for consecutively 14 days. Measure the tumor size 2-3 times every week. Results: Hu Prime1-NSCLC mutant sensitive xenograft model research data showed that reversible tyrosine kinase inhibitors gefitinib, erlotinib and irreversible tyrosine kinase inhibitor afatinib could effectively inhibit tumor growth in EGFR positive NSCLC allografts model. The pharmacodynamic activity of irreversible inhibitor was better than that of the reversible inhibitor. Specimens from clinical anthropogenic tumor retain characteristics of the human primary malignancy, histopathology, biological characteristics, and tumor markers, etc., which can more accurately reflect the characteristics of the tumor and the impact of interventions. Conclusion: The model is not only a good antitumor drug experimental platform, but also a new evaluation tool of individualized medication.

基于FLAC^(3D)梁单元修正的隧道/巷道拱架支护模拟方法(英文)

目的:基于常用的数值模拟软件FLAC^(3D)进行二次开发,弥补现有数值模拟方法的缺陷,提出一种准确有效的隧道/巷道拱架支护数值模拟方法。创新点:1.引入抗弯和抗压能力的相关性,改进梁单元压弯极限判据;2.通过FISH语言编程,实现梁单元修正和拱架精确模拟。方法:1.通过对FLAC^(3D)中梁单元支撑理论的分析,明确其存在的缺陷,并利用算例进行证实(图4~6);2.基于传统强度理论,对梁单元现有压弯极限判据进行改进(图7和8);3.通过FISH语言编程,实现梁单元修正模型嵌入(图9);4.通过算例分析,对新模拟方法的效果进行验证(图10和13)。结论:1.改进了梁单元压弯极限判据,通过FISH语言编程实现了梁单元的修正及拱架屈服失效的模拟。2.构件压弯试验和巷道拱架支护实例分析表明:修正模型体现了在压弯组合荷载作用下梁单元屈服时弯矩和轴力的相关性;实现程序是有效的且灵敏度较高;提出的新模拟方法使计算偏差得到有效压制,拱架模型呈现出的力学行为及围岩支护作用更加接近实际,计算精度和设计可靠度更高。