BACKGROUND Transduodenal ampullectomy(TDA) is not in wide clinical use due to its low radical effect and a high recurrence rate of tumors. However,TDA is still an effective treatment method; it has great clinical valu...BACKGROUND Transduodenal ampullectomy(TDA) is not in wide clinical use due to its low radical effect and a high recurrence rate of tumors. However,TDA is still an effective treatment method; it has great clinical value in cases of duodenal benign tumors,precancerous lesions,and benign and malignant borderline tumors,and can avoid the risks associated with pancreaticoduodenectomy with larger resection range and greater thoroughness than endoscopic papillectomy.AIM To investigate the surgical method choice and the coincidence rate of pathological diagnoses in TDA for ampullary neoplasms.METHODS Ten patients with ampullary neoplasms underwent TDA based on the fact that their endoscopic biopsy results suggested benign lesions,and the endoscopic ultrasound(EUS)-assessed tumors were resectable. All cases underwent duodenal ampullary lesion endoscopic biopsy,intraoperative frozen-section pathological examination,and postoperative pathological examination.RESULTSThis study included seven patients with benign tumors and three with malignant tumors(1 pTis,2 pT1),according to the postoperative pathology results. The coincidence rate of the postoperative pathology results with the intraoperative frozen-section biopsy results was 100%(10/10),and the coincidence rate with the endoscopic biopsy results was 70%(7/10) based on pathological characteristics.The endoscopic biopsy false-negative rate was 30%(3/10). All patients were followed for 6 to 70 mo without tumor recurrence or metastasis.CONCLUSION The coincidence rate of postoperative pathology results,intraoperative frozensection pathology results,and endoscopic biopsy results is the restraining factor of TDA clinical application. Endoscopic biopsy results and EUS have importance relevance to surgical planning. Intraoperative frozen-section pathology results have a significant influence on the choice of surgical procedure.展开更多
The EFIT program is integrated with the high resolution laser polarimeter interferometer system（POLARIS）, the soft X-ray imaging diagnostic system（SXR） and the electron cyclotron emission radiometer（ECE） in the ...The EFIT program is integrated with the high resolution laser polarimeter interferometer system（POLARIS）, the soft X-ray imaging diagnostic system（SXR） and the electron cyclotron emission radiometer（ECE） in the J-TEXT tokamak. Then some internal information about Faraday angle and the position of safety factor q=1 can be obtained as a constraint to EFIT. The modified EFIT code is used to calculate the internal parameters such as flux function, safety factor q, pressure and current density.展开更多
Leeches and earthworms are the main ingredients of Shuxuetong injection compositions,whichare natural biomedicines.Near infrared(NIR)diffuse reflection spectroscopy has been used forquality assurance of Chinese medici...Leeches and earthworms are the main ingredients of Shuxuetong injection compositions,whichare natural biomedicines.Near infrared(NIR)diffuse reflection spectroscopy has been used forquality assurance of Chinese medicines.In the present work,NIR spectroscopy was proposed as arapid and nondestructive technique to assess the moisture content(MC),soluble solid content(SSC)and hypoxanthine content(HXC)of leeches and earthworms.This study goal was toimprove NIR models for accurate quality control of leech and earthworm using outlier multiplediagnoses(OMD).OMD was composed of four outlier detection methods:spectrum outlier di-agnostic(MD),leverage diagnostic(LD),principal component scores diagnostic(PCSD)andfactor loading diagnostic(FLD),Conventional outlier diagnoses(MD,LD)and OMD werecompared,and the best NIR models were those based on OMD.The correlation coefficients(R)for leech were 0.9779,0.9616 and 0.9406 for MC,SSC and HXC,respectively.The values ofrelative standard error of prediction(RSEP)for leech were 2.3%,5.1%and 9.0%for MC,SSC and HXC,respectively.The values of R for earthworm were 0.9478,0.9991 and 0.9605 for MC,SSC and HXC,respectively.The values of RSEP for earthworm were 8.8%,2.4%and 12%for MC,SSC and HXC,respectively.The performance of the NIR models was certainly improved by OMD.展开更多
BACKGROUND Missed or delayed diagnosis of cervical spine instability after acute trauma can have catastrophic consequences for the patient,resulting in severe neurological impairment.Currently,however,there is no cons...BACKGROUND Missed or delayed diagnosis of cervical spine instability after acute trauma can have catastrophic consequences for the patient,resulting in severe neurological impairment.Currently,however,there is no consensus on the optimal strategy for diagnosing occult cervical spine instability.Thus,we present a case of occult cervical spine instability and provide a clinical algorithm to aid physicians in diagnosing occult instability of the cervical spine.CASE SUMMARY A 57-year-old man presented with cervical spine pain and inability to stand following a serious fall from a height of 2 m.No obvious vertebral fracture or dislocation was found at the time on standard lateral X-ray,computed tomography,and magnetic resonance imaging(MRI).Subsequently,the initial surgical plan was unilateral open-door laminoplasty(C3-7)with alternative levels of centerpiece mini-plate fixation(C3,5,and 7).However,the intraoperative C-arm fluoroscopic X-rays revealed significantly increased intervertebral space at C5-6,indicating instability at this level that was previously unrecognized on preoperative imaging.We finally performed lateral mass fixation and fusion at the C5-6 level.Looking back at the preoperative images,we found that the preoperative T2 MRI showed non-obvious high signal intensity at the C5-6 intervertebral disc and posterior interspinous ligament.CONCLUSION MRI of cervical spine trauma patients should be carefully reviewed to detect disco-ligamentous injury,which will lead to further cervical spine instability.In patients with highly suspected cervical spine instability indicated on MRI,lateral X-ray under traction or after anesthesia and muscle relaxation needs to be performed to avoid missed diagnoses of occult cervical instability.展开更多
基金Supported by the Key Research and Development Plan of Shandong Province,No.2016GSF201108
文摘BACKGROUND Transduodenal ampullectomy(TDA) is not in wide clinical use due to its low radical effect and a high recurrence rate of tumors. However,TDA is still an effective treatment method; it has great clinical value in cases of duodenal benign tumors,precancerous lesions,and benign and malignant borderline tumors,and can avoid the risks associated with pancreaticoduodenectomy with larger resection range and greater thoroughness than endoscopic papillectomy.AIM To investigate the surgical method choice and the coincidence rate of pathological diagnoses in TDA for ampullary neoplasms.METHODS Ten patients with ampullary neoplasms underwent TDA based on the fact that their endoscopic biopsy results suggested benign lesions,and the endoscopic ultrasound(EUS)-assessed tumors were resectable. All cases underwent duodenal ampullary lesion endoscopic biopsy,intraoperative frozen-section pathological examination,and postoperative pathological examination.RESULTSThis study included seven patients with benign tumors and three with malignant tumors(1 pTis,2 pT1),according to the postoperative pathology results. The coincidence rate of the postoperative pathology results with the intraoperative frozen-section biopsy results was 100%(10/10),and the coincidence rate with the endoscopic biopsy results was 70%(7/10) based on pathological characteristics.The endoscopic biopsy false-negative rate was 30%(3/10). All patients were followed for 6 to 70 mo without tumor recurrence or metastasis.CONCLUSION The coincidence rate of postoperative pathology results,intraoperative frozensection pathology results,and endoscopic biopsy results is the restraining factor of TDA clinical application. Endoscopic biopsy results and EUS have importance relevance to surgical planning. Intraoperative frozen-section pathology results have a significant influence on the choice of surgical procedure.
文摘The EFIT program is integrated with the high resolution laser polarimeter interferometer system（POLARIS）, the soft X-ray imaging diagnostic system（SXR） and the electron cyclotron emission radiometer（ECE） in the J-TEXT tokamak. Then some internal information about Faraday angle and the position of safety factor q=1 can be obtained as a constraint to EFIT. The modified EFIT code is used to calculate the internal parameters such as flux function, safety factor q, pressure and current density.
文摘Leeches and earthworms are the main ingredients of Shuxuetong injection compositions,whichare natural biomedicines.Near infrared(NIR)diffuse reflection spectroscopy has been used forquality assurance of Chinese medicines.In the present work,NIR spectroscopy was proposed as arapid and nondestructive technique to assess the moisture content(MC),soluble solid content(SSC)and hypoxanthine content(HXC)of leeches and earthworms.This study goal was toimprove NIR models for accurate quality control of leech and earthworm using outlier multiplediagnoses(OMD).OMD was composed of four outlier detection methods:spectrum outlier di-agnostic(MD),leverage diagnostic(LD),principal component scores diagnostic(PCSD)andfactor loading diagnostic(FLD),Conventional outlier diagnoses(MD,LD)and OMD werecompared,and the best NIR models were those based on OMD.The correlation coefficients(R)for leech were 0.9779,0.9616 and 0.9406 for MC,SSC and HXC,respectively.The values ofrelative standard error of prediction(RSEP)for leech were 2.3%,5.1%and 9.0%for MC,SSC and HXC,respectively.The values of R for earthworm were 0.9478,0.9991 and 0.9605 for MC,SSC and HXC,respectively.The values of RSEP for earthworm were 8.8%,2.4%and 12%for MC,SSC and HXC,respectively.The performance of the NIR models was certainly improved by OMD.
基金Supported by grants from China Postdoctoral Science Foundation General Program No.2019M653417Sichuan Science and Technology Program,No.2020YJ0025,No.2017SZ0046,and No.2017SZDZX0021+1 种基金Post-Doctor Research Project,Sichuan University,No.2019SCU12043and International Postdoctoral Exchange Fellowship Program,No.PC2019060.
文摘BACKGROUND Missed or delayed diagnosis of cervical spine instability after acute trauma can have catastrophic consequences for the patient,resulting in severe neurological impairment.Currently,however,there is no consensus on the optimal strategy for diagnosing occult cervical spine instability.Thus,we present a case of occult cervical spine instability and provide a clinical algorithm to aid physicians in diagnosing occult instability of the cervical spine.CASE SUMMARY A 57-year-old man presented with cervical spine pain and inability to stand following a serious fall from a height of 2 m.No obvious vertebral fracture or dislocation was found at the time on standard lateral X-ray,computed tomography,and magnetic resonance imaging(MRI).Subsequently,the initial surgical plan was unilateral open-door laminoplasty(C3-7)with alternative levels of centerpiece mini-plate fixation(C3,5,and 7).However,the intraoperative C-arm fluoroscopic X-rays revealed significantly increased intervertebral space at C5-6,indicating instability at this level that was previously unrecognized on preoperative imaging.We finally performed lateral mass fixation and fusion at the C5-6 level.Looking back at the preoperative images,we found that the preoperative T2 MRI showed non-obvious high signal intensity at the C5-6 intervertebral disc and posterior interspinous ligament.CONCLUSION MRI of cervical spine trauma patients should be carefully reviewed to detect disco-ligamentous injury,which will lead to further cervical spine instability.In patients with highly suspected cervical spine instability indicated on MRI,lateral X-ray under traction or after anesthesia and muscle relaxation needs to be performed to avoid missed diagnoses of occult cervical instability.
