Background Patients with central tracheobronchial benign or malignant lesions who have not recieved surgical treatment can be treated by interventional techniques, such as laser, afterloading radiotherapy, cryotherapy...Background Patients with central tracheobronchial benign or malignant lesions who have not recieved surgical treatment can be treated by interventional techniques, such as laser, afterloading radiotherapy, cryotherapy, photodynamics treatment, radiofrequency ablation and stenting, etc. The accuracy of the invasive depth of central lesion in tracheobronchial wall plays an important role in making interventional treatment plan. This study used radial probe endobronchial ultrasound （RP-EBUS） scanning to evaluate the accuracy of the invasive depth of central lesions in tracheobronchial wall, and the influence of RP-EBUS scanning in treatment plan making and guidance. Methods This was a prospective study of consecutive patients with central tracheobronchial lesions found by CT or bronchoscopy. We performed EBUS scanning after common bronchoscopy under local anesthesia. A radial ultrasonic probe （2.0 mm in diameter with 20-MHz frequency） with a balloon sheath was introduced through the 2.8-mm-diameter channel of a flexible bronchoscope. The balloon at the tip of the probe was inflated with distilled water until coupling with the airway wall under endoscopic control. The circular image of EBUS, which revealed the layered structure of the tracheobronchial wall, could be achieved. Results Total of 125 patients were enrolled in the study. Thirty patients underwent surgical operation and pathologically proved the RP-EBUS diagnosis accuracy of tumor invasive depth in tracheobroncial wall was 90% （27/30）, sensitivity and specificity were 88.89% （24/27） and 100% （3/3）, respectively. In response to EBUS images, 40 approaches were altered or guided： lymph-node metastasis and compressive lesions was diagnosed by EBUS-guided transbronchial needle aspiration （TBNA） （n=8）; Lesions ablation with laser or electricity were stopped when EBUS demonstrated close range with vessels or perforation possibility （n=13）, stents size were changed （n=14）, operation was canceled （n=3） and foreign body was removed （n=2）. No complication associated with the use of EBUS was observed. Conclusion RP-EBUS can be a useful tool in assessing the central lesion invasive depth to the tracheobronchial wall.展开更多
Objective To study direct cortical electrical stimulation technique for the recording of motor evoked potentials under general anesthesia in central sulcus lesions. Methods The largest N20-P25 response was recorded fr...Objective To study direct cortical electrical stimulation technique for the recording of motor evoked potentials under general anesthesia in central sulcus lesions. Methods The largest N20-P25 response was recorded from postcentral gyrus by intraoperative monitoring of cortical motor evoked potentials in 10 patients with intracranial lesions near or in the central area. The muscles of upper extremity in all patients were activated by delivering stimulus to cortical areas continuously. Moving the cortical electrodes forward, the largest P20-N25 response, SEP phase reversal,was obtained as a motor center stimulus. In this site of cortex, a short train stimulation elicited reproducible muscle action potentials that could be observed from the oscilloscope without averaging.Results MEPs can be recorded, pre-and post-operatively, without motor deficits of upper limbs in all patients.Conclusion This technique seems to be preferable for intraoperative localization of motor evoked potentials in central sulcus lesions under total intravenous anesthesia.展开更多
目的:比较两种方法修复上中切牙大面积切角缺损的临床疗效。方法:选择59例(60颗牙)患者,采用随机方法分为两组,A组仅使用复合树脂修复,B组使用复合树脂加自攻螺纹钉联合修复,于修复后3年以改良美国公共健康部(United States Public Heal...目的:比较两种方法修复上中切牙大面积切角缺损的临床疗效。方法:选择59例(60颗牙)患者,采用随机方法分为两组,A组仅使用复合树脂修复,B组使用复合树脂加自攻螺纹钉联合修复,于修复后3年以改良美国公共健康部(United States Public Health Service,USPHS)制定的评定系统标准记录修复效果。结果:采用配对χ2检验,比较两种修复方法在修复效果上无显著差异(P>0.05)。结论:通过3年临床观察,单纯用复合树脂修复上中切牙大面积切角缺损具有较好的应用效果。展开更多
文摘Background Patients with central tracheobronchial benign or malignant lesions who have not recieved surgical treatment can be treated by interventional techniques, such as laser, afterloading radiotherapy, cryotherapy, photodynamics treatment, radiofrequency ablation and stenting, etc. The accuracy of the invasive depth of central lesion in tracheobronchial wall plays an important role in making interventional treatment plan. This study used radial probe endobronchial ultrasound （RP-EBUS） scanning to evaluate the accuracy of the invasive depth of central lesions in tracheobronchial wall, and the influence of RP-EBUS scanning in treatment plan making and guidance. Methods This was a prospective study of consecutive patients with central tracheobronchial lesions found by CT or bronchoscopy. We performed EBUS scanning after common bronchoscopy under local anesthesia. A radial ultrasonic probe （2.0 mm in diameter with 20-MHz frequency） with a balloon sheath was introduced through the 2.8-mm-diameter channel of a flexible bronchoscope. The balloon at the tip of the probe was inflated with distilled water until coupling with the airway wall under endoscopic control. The circular image of EBUS, which revealed the layered structure of the tracheobronchial wall, could be achieved. Results Total of 125 patients were enrolled in the study. Thirty patients underwent surgical operation and pathologically proved the RP-EBUS diagnosis accuracy of tumor invasive depth in tracheobroncial wall was 90% （27/30）, sensitivity and specificity were 88.89% （24/27） and 100% （3/3）, respectively. In response to EBUS images, 40 approaches were altered or guided： lymph-node metastasis and compressive lesions was diagnosed by EBUS-guided transbronchial needle aspiration （TBNA） （n=8）; Lesions ablation with laser or electricity were stopped when EBUS demonstrated close range with vessels or perforation possibility （n=13）, stents size were changed （n=14）, operation was canceled （n=3） and foreign body was removed （n=2）. No complication associated with the use of EBUS was observed. Conclusion RP-EBUS can be a useful tool in assessing the central lesion invasive depth to the tracheobronchial wall.
基金Science and Technology Committee of Shanghai, China (024119019).
文摘Objective To study direct cortical electrical stimulation technique for the recording of motor evoked potentials under general anesthesia in central sulcus lesions. Methods The largest N20-P25 response was recorded from postcentral gyrus by intraoperative monitoring of cortical motor evoked potentials in 10 patients with intracranial lesions near or in the central area. The muscles of upper extremity in all patients were activated by delivering stimulus to cortical areas continuously. Moving the cortical electrodes forward, the largest P20-N25 response, SEP phase reversal,was obtained as a motor center stimulus. In this site of cortex, a short train stimulation elicited reproducible muscle action potentials that could be observed from the oscilloscope without averaging.Results MEPs can be recorded, pre-and post-operatively, without motor deficits of upper limbs in all patients.Conclusion This technique seems to be preferable for intraoperative localization of motor evoked potentials in central sulcus lesions under total intravenous anesthesia.
文摘目的:比较两种方法修复上中切牙大面积切角缺损的临床疗效。方法:选择59例(60颗牙)患者,采用随机方法分为两组,A组仅使用复合树脂修复,B组使用复合树脂加自攻螺纹钉联合修复,于修复后3年以改良美国公共健康部(United States Public Health Service,USPHS)制定的评定系统标准记录修复效果。结果:采用配对χ2检验,比较两种修复方法在修复效果上无显著差异(P>0.05)。结论:通过3年临床观察,单纯用复合树脂修复上中切牙大面积切角缺损具有较好的应用效果。
