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Early endoscopic management of an infected acute necrotic collection misdiagnosed as a pancreatic pseudocyst: A case report

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 609-615页

作者： Hong-Ying Zhang Chen-Cong He department of Gastroenterology Jinhua People's HospitalJinhua 321000Zhejiang ProvinceChina department of General Medicine Jinhua Guangfu HospitalJinhua 321001Zhejiang ProvinceChina

BACKGROUND Infected acute necrotic collection(ANC)is a fatal complication of acute pancre-atitis with substantial morbidity and mortality.Drainage plays an exceedingly important role as the first step in invasive intervention for infected necrosis;however,there is great controversy about the optimal drainage time,and better treatment should be explored.CASE SUMMARY We report the case of a 43-year-old man who was admitted to the hospital with severe intake reduction due to early satiety 2 wk after treatment for acute pancre-atitis;conservative treatment was ineffective,and a pancreatic pseudocyst was suspected on contrast-enhanced computed tomography(CT).Endoscopic ultra-sonography(EUS)suggested hyperechoic necrotic tissue within the cyst cavity.The wall was not completely mature,and the culture of the puncture fluid was positive for A-haemolytic Streptococcus.Thus,the final diagnosis of ANC in-fection was made.The necrotic collection was not walled off and contained many solid components;therefore,the patient underwent EUS-guided aspiration and lavage.Two weeks after the collection was completely encapsulated,pancreatic duct stent drainage via endoscopic retrograde cholangiopancreatography(ERCP)was performed,and the patient was subsequently successfully discharged.On repeat CT,the pancreatic cysts had almost disappeared during the 6-month fo-llow-up period after surgery.CONCLUSION Early EUS-guided aspiration and lavage combined with late ERCP catheter drainage may be effective methods for intervention in infected ANCs.

关键词： Infected acute necrotic collection Pancreatic pseudocyst Endoscopic ultrasonography Endoscopic retrograde cholangiopancreatography Endoscopic ultrasound-guided fine-needle aspiration Case report

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Assessment of radiation protection knowledge and practices among radiographers in the central region of Ghana

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Radiation Medicine and Protection 2022年第3期3卷 146-151页

作者： Emmanuel Fiagbedzi Philip Nii Gorleku Savanna Nyarko Adomako Asare Gideon Ackah Ndede department of Medical Imaging Technology and sonography College of Health and Allied SciencesUniversity of Cape CoastCape CoastGhana

Objective:To assess the radiation protection practices and knowledge among radiographers in the central region of Ghana.Methods:A cross-sectional study was carried out among practicing radiographers in three selected hospitals.The study was carried out from January to October 2021.A self-administered questionnaire comprising three sections was given out to 20 participants to answer.Data were analyzed statistically using the Statistical Package for Social Sciences(SPSS)version 25.0 and logistic regression analysis.Results:The study revealed that over ninety percent of the radiographers had dosimeters but only 25%wear them always.Adherence to radiation protection measures and practices was found to be generally fairly satisfactory,but was high in the age group 35-45.However,Knowledge of radiation protection practices amongst the radi-ographers was generally high.Working experience of fewer than 5 years(P=0.035)gave a high odds ratio(OR)and was of a significant value in determining the radiation training and courses undertaken by these radiographers.Conclusions:The adherence to radiation protection practices was fairly satisfactory,and the knowledge of radi-ation protection practices was generally high,but that is not enough.There is more room for improvement to ensure knowledge is put into practice to enhance proper safety measures,ensure effective work,and overall reduce the negative effects of ionizing radiation.

关键词： Radiographer Radiation protection Practices Ionizing radiations

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L-Fucose inhibits the progression of cholangiocarcinoma by causing microRNA-200b overexpression

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Chinese Medical Journal 2022年第24期135卷 2956-2967页

作者： Biqiang Zhu Jingjing Zheng Gaichao Hong Tao Bai Wei Qian Jinsong Liu Xiaohua Hou Division of Gastroenterology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China department of Diagnostic Medical sonography The Central Hospital of WuhanTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430014China

Background:Cholangiocarcinoma(CCA)is a malignant biliary tract tumor with an extremely poor prognosis.There is an urgent demand to explore novel therapeutic strategies.L-fucose has been confirmed to participate in anti-inflammation and antitumor activities.However,the effect of L-fucose on the progression of CCA has not been well investigated.This study aimed to determine whether L-fucose induced the inhibition of CCA and its possible mechanism.Methods:The anti-growth activity was determined using Cell Counting Kit-8 assay,colony formation assays,Annexin V-fluorescein isothiocyanate/propidium iodide(FITC/PI)assay,and cell cycle analysis.The anti-metastasis activity was determined by wound healing,transwell,and invasion assays.The anti-angiogenesis activity was determined by tube formation and transwell assays.MicroRNAs that may be involved in the L-fucose-induced CCA inhibition was analyzed using bioinformatics methods.The preclinical therapeutic efficacy was mainly estimated by ultrasound in xenograft nude mouse models.Differences were analyzed via Student’s t test or one-way analysis of variance.Results:L-Fucose induced apoptosis and G0/G1 cell cycle arrest,inhibited cell epithelial-mesenchymal transition of CCA cells,and additionally inhibited tube formation of human umbilical vein endothelial cells(HUVECs)in a dose-dependent manner,leading to a decrease in cell proliferation,metastasis,and angiogenesis.Mechanistically,L-fucose induced microRNA-200b(miR-200b)upregulation,and mitogen-activated protein kinase 7(MAPK7)downregulation was found to be targeted by miR-200b,with decreased cell proliferation and metastasis.Additionally,phosphorylated signal transducer and activator of transcription 3 was found to be downregulated after L-fucose treatment.Finally,in vivo experiments in CCA xenograft models also confirmed the antitumor properties of L-fucose.Conclusion:L-Fucose inhibited the progression of CCA via the miR-200b/MAPK7 and signal transducer and activator of transcription 3 signaling pathways.

关键词： Cholangiocarcinoma L-Fucose MicroRNA-200b Mitogen-activated protein kinase 7 Phosphorylated signal transducer and activator of transcription 3

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Ultrasonic diagnosis and vasoactive substances examination in patients with cirrhosis

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Asian Pacific Journal of Tropical Medicine 2014年第4期7卷 329-332页

作者： Mei Fan Chun Su Lin Lu Jun-Chang Qin Pei Li Jia-Ying Yuan department of sonography The First Affiliated Hospital of Zhengzhou University department of Gynaecology and Obstetrics the Fifth Affiliated Hospital of Zhengzhou University department of Radiology the Third Affiliated Hospital of Zhengzhou University department of Pathophysiology College of Basic Medical SciencesZhengzhou University department of sonography the Affiliated Hospital of Henan Military Region

Objective:To investigate hemodynamic change of patients with cirrhosis by using Color Doppler ultrasound technique and to explore the significance of change in the content of vasoactive substances-plasma endothelin-1(ET-1)and calcitonin gene-related peptide(CGRP).Methods:A total of 178 cases with cirrhosis were regarded as study groups,and were divided into three degrees:A,B and C according to child-pugh and meanwhile 60 cases were regarded as normal control group.Portal vein and splenic vein of patients were explored by adopting Color Doppler ultrasound technique,related indexes were recorded and the blood flow as well as their ration in the two groups was calculated.Radio immunoassay was adopted to detect the content of plasma ET-1 and CGRP in both study group and contrast group.Results:Compared with the healthy cases in the contrast group,there was abnormal hemodynamics in the system of portal vein of patients with cirrhosis and the content of plasma ET-1 and CGRP was increased obviously.In the Child-Pugh liver function grades,the content of ET-1 and CGRP was increased as the degree of cirrhosis became more and more serious.There was no significant difference in the comparison between those without ascites and those in contrast group(P>0.05),the content of plasma ET-1and CGRP in patients without ascites was increased remarkably.Besides,there was positive correlation between the content of plasma ET-1 and CGRP and Dpv,Dsv and Qsv.Conclusion:Dotection of abnormal hemodynamics of portal vein and splenic vein by Color Doppler ultrasound technique can be one of the means for diagnosis of hypertension.Plasma ET-1 and CGRP of patients with cirrhosis reflect the serious degree of the damage in live function and play an important role in the formation and development of portal hypertension.

关键词： Cirrhosis Color Doppler ultrasound technique Venous hemodynamics ET-1 CGRP

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Pseudomyxoma peritonei of 92 Chinese patients:Clinical characteristics,pathological classification and prognostic factors

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World Journal of Gastroenterology 2012年第24期18卷 3081-3088页

作者： Ai-Tao Guo Yan-Mi Li Li-Xin Wei department of Pathology the Gen- eral Hospital of the People's Liberation Army Beijing 100853 China department of sonography the General Hospital ot the People's Liberation Army Beijing 100853 China

AIM:To assess the clinicopathologic features and its relationship with prognosis of pseudomyxoma peritonei(PMP) in Chinese patients.METHODS:The clinicopathologic features and followup data of 92 patients with PMP were reviewed and retrospectively analyzed.The cases were categorized into three groups:disseminated peritoneal adenomucinosis(DPAM),peritoneal mucinous carcinomatosis(PMCA),and peritoneal mucinous carcinomatosis with intermediate or discordant features(PMCA-I/D).The log-rank test was used to analyze survival for each group and various clinicopathological parameters.Multivariate Cox proportional-hazard models were constructed to determine the important factors associated with survival.RESULTS:The median age at diagnosis was 51.9 years(range:22-76 years).The median follow up was 124 mo.The 3-,5-and 10-year survival rates were 74.0%,67.4% and 49.1%,respectively.There were 49(53.2%)patients with DPAM,26(28.3%) with PMCA-I and 17(18.5%) with PMCA.Patients with DPAM,PMCA-I/D and PMCA exhibited statistically significant difference in survival(P = 0.001).The 3 year survival for DPAM,PMCAI/D and PMCA was 97.0%,80.0% and 67.0%,respectively;the 5 year survival was 80.0%,67.0% and 50.0%,respectively;and the 10 year survival was 65.0%,28.0% and 14.0%,respectively.Survival rate was significantly lowest in patients < 40 age years of age(P = 0.011).Appendiceal tumor and extra-ovarian parenchymal organ involvement were significantly related to overall survival.Patients with appendiceal mucinous adenocarcinoma(MACA) showed the significantly poorer prognosis(P = 0.011).Multivariate analysis showed that pathological classification,age,appendiceal tumor were significant related to overall survival.CONCLUSION:The clinical process "PMP" should be pathologically classified into DPAM,PMCA and PMCA-I/D.Pathological classification,age,appendiceal MACA are survival independent predictors in Chinese patients with PMP.

关键词：病理特点临床特点患者粘液腹膜中国预后假性

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Sonographic evaluation of vessel grafts in living donor liver transplantation recipients of the right lobe

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World Journal of Gastroenterology 2009年第28期15卷 3550-3554页

作者： Qiang Lu Hong Wu Yu-Ting Fan Yan Luo Zhong-Wei Zhang department of sonography West China Hospital Sichuan University Chengdu 610041China Liver Transplantation Center West China Hospital Sichuan University Chengdu 610041China

AIM:To evaluate the vessel grafts(VG) used to reconstruct the middle hepatic vein(MHV) tributaries with ultrasonography.METHODS:Twenty-four patients undergone living donor liver transplantation were enrolled in our study.MHV tributaries larger than 5 mm in diameter were reconstructed with interposition VG.Blood flow of the graft and interposition VG was checked by Doppler ultrasonography daily in the f irst 2 postoperative weeks and monthly followed up after discharge.The sensitivity of VG detected by ultrasonography was assessed using surgical records as references.Student's t test was used to compare the velocity of VG and occluded VG in chronic patents(> 3 mo).RESULTS:Thirty-one VG were used to reconstruct the MHV tributaries.Ultrasonography identif ied 96.7%(30/31) of large MHV tributaries and 90.3%(28/31) of VG.The diameter of VG was 5.6 ± 0.8 mm and the velocity of VG was 19.7 ± 8.1 cm/s.Two VG(2/31, 6.5%) were occluded on the f irst postoperative day in one patient who suffered from persistent ascites and had a prolonged recovery of liver function.Twenty-six VG(26/31, 83.9%) were patent 2 wk after operation.Six(6/31, 19.4%) VG were patent over 3 mo after operation.Intrahepatic venous collaterals were detected in 29.2%(7/24) patients.The velocity of VG andoccluded VG was 30.1 ± 5.6 cm/s, 16.5 ± 5.8 cm/s, respectively, in chronic patents.The difference between two groups was statistically signif icant(P < 0.001).CONCLUSION:Our results indicate that most VG are patent in the flrst postoperative week while only a small portion with a higher velocity remains patent after 3 mo.Intrahepatic venous collaterals can be observed in some patients after occlusion of VG.

关键词：肝移植超声评价生活血管

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Dynamic changes of renal cortical blood perfusion before and after percutaneous transluminal renal artery stenting in patients with severe atherosclerotic renal artery stenosis

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Chinese Medical Journal 2022年第13期135卷 1570-1577页

作者： Na Ma Yan Li Siyu Wang Mengpu Li Yongjun Li Hu Ai Hui Zhu Yang Wang Fajin Guo Junhong Ren department of sonography Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical ScienceBeijing 100730China department of Vascular Surgery National Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical ScienceBeijing 100730China department of Cardiology National Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical ScienceBeijing 100730China department of Nuclear Medicine National Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical ScienceBeijing 100730China department of Medical Research&Biometrics Center National Center for Cardiovascular Diseases and Fuwai HospitalCAMS and PUMCBeijing 100037China.

Background:This study aims to observe the dynamic changes of renal artery(RA)disease and cortical blood perfusion(CBP)evaluated by contrast-enhanced ultrasound(CEUS)after percutaneous transluminal renal artery stenting(PTRAS)in patients with severe atherosclerotic renal artery stenosis(ARAS)and to analyze the relationship between CBP and prognosis.Methods:This was a single-center retrospective cohort study.A total of 98 patients with unilateral severe ARAS after successful PTRAS in Beijing Hospital from September 2017 to September 2020 were included.According to renal glomerular filtration rate(GFR)detected by radionuclide imaging at 12 months after PTRAS,all patients were divided into the poor prognosis group(n=21,GFR decreased by≥20%compared with baseline)and the control group(n=77,GFR decreased by<20%or improved compared with baseline).Renal artery stenosis was diagnosed by digital subtraction angiography,and renal CBP was evaluated by CEUS using TomTec Imaging Systems(Germany)before PTRAS,at 6 months and 12 months after discharge.The receiver operating characteristic(ROC)curve with area under the curve(AUC)was used to analyze the predictive value of CBP parameters,including area under ascending curve(AUC1),area under the descending curve(AUC2),rising time(RT),time to peak intensity(TTP),maximum intensity(IMAX),and mean transit time(MTT)for poor prognosis.Results:Among the 98 patients,there were 52 males(53.1%),aged 55–74 years old,with an average age of 62.1±8.7 years,and an average artery stenosis of 82.3±12.9%.The poor prognosis group was associated with significantly increased incidence of diabetes(76.2%vs.41.6%),and lower levels of GFR of the stenotic kidney(21.8 mL/min vs.25.0 mL/min)and total GFR(57.6 mL/min vs.63.7 mL/min)(all P<0.05),compared with the control group(P<0.05).In addition,the rate of RA restenosis was significantly higher in the poor prognosis group than in the control group(9.5%vs.0,χ^(2)=9.462,P=0.002).Compared with the control group,the poor prognosis group was associated with signific

关键词： Atherosclerotic renal artery stenosis Percutaneous transluminal renal artery stenting Contrast-enhanced ultrasound Renal cortical blood perfusion Follow-up

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CEUS: A new imaging approach for postoperative vascular complications after right-lobe LDLT

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World Journal of Gastroenterology 2009年第29期15卷 3670-3675页

作者： Yan Luo Yu-Ting Fan Qiang Lu Bo Li Tian-Fu Wen Zhong-Wei Zhang department of sonography West China Hospital Sichuan University Chengdu 610041Sichuan Province China Liver TransplantationCenter West China Hospital Sichuan University Chengdu610041 Sichuan Province China

AIM: To investigate contrast-enhanced ultrasound (CEUS) for early diagnosis of postoperative vascular complications after right-lobe living donor liver transplantation (RLDLT). METHODS: The ultrasonography results of 172 patients who underwent RLDLT in West China Hospital, Sichuan University from January 2005 to June 2008 were analyzed retrospectively. Among these 172 patients, 16 patients' hepatic artery flow and two patients' portal vein flow was not observed by Doppler ultrasound, and 10 patients' bridging vein flow was not shown by Doppler ultrasound and there was a regional inhomogeneous echo in the liver parenchyma upon 2D ultrasound. Thus, CEUS examination was performed in these 28 patients. RESULTS: Among the 16 patients without hepatic artery flow at Doppler ultrasound, CEUS showed nine cases of slender hepatic artery, six of hepatic arterial thrombosis that was confirmed by digital subtraction angiography and/or surgery, and one of hepatic arterial occlusion with formation of lateral branches. Among the two patients without portal vein flow at Doppler ultrasound, CEUS showed one case of hematoma compression and one of portal vein thrombosis,and both were confirmed by surgery. Among the 10 patients without bridging vein flow and with liver parenchyma inhomogeneous echo, CEUS showed regionally poor perfusion in the inhomogeneous area, two of which were confirmed by enhanced computed tomography (CT), but no more additional information about bridging vein flow was provided by enhanced CT. CONCLUSION: CEUS may be a new approach for early diagnosis of postoperative vascular complications after RLDLT, and it can be performed at the bedside.

关键词：成像方法并发症肝移植血管活体造影超声

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Management of heterotopic cesarean scar pregnancy with preservation of intrauterine pregnancy:A case report

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World Journal of Clinical Cases 2021年第22期9卷 6428-6434页

作者： Zheng-Yun Chen Yong Zhou Yue Qian Jia-Min Luo Xiu-Feng Huang Xin-Mei Zhang department of Gynecology Women’s Hospital School of MedicineZhejiang UniversityHangzhou 310006Zhejiang ProvinceChina department of sonography Women’s Hospital School of MedicineZhejiang UniversityHangzhou 310006Zhejiang ProvinceChina

BACKGROUND Heterotopic cesarean scar pregnancy(HCSP)is very rare and has a high risk of massive uterine bleeding.Preservation of concurrent intrauterine pregnancy(IUP)is one of the great challenges in the management of HCSP.No universal treatment protocol has been established when IUP is desired to be preserved.CASE SUMMARY We report a case of HCSP at 8+wk gestation in a 34-year-old woman with stable hemodynamics.A two-step intervention was applied.Selective embryo aspiration was performed first,and surgical removal of ectopic gestational tissue by suction and curettage was performed 2 d later.Both steps were performed under ultrasound guidance.The patient had an uneventful course,and a healthy baby was delivered at 34+6 wk gestation.CONCLUSION Selective embryo aspiration followed by suction and curettage was successful in the preservation of IUP in the management of HCSP.This approach is an alternative option for HCSP in the first trimester when the IUP is desired to be preserved.

关键词： Cesarean scar Embryo aspiration Heterotopic pregnancy Intervention Suction and curettage Case report

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Living donor liver transplantation using dual grafts:Ultrasonographic evaluation

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World Journal of Gastroenterology 2010年第31期16卷 3979-3983页

作者： Qiang Lu Yu-Ting Fan Yan Luo Hong Wu Lv-Nan Yan Zhe-Yu Chen department of sonography West China Hospital Sichuan University Chengdu 610041 Sichuan Province China Liver Transplantation Center We st China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

AIM: To evaluate the dual-graft living donor liver transplantation (LDLT) with ultrasonography, with special emphasis on the postoperative complications. METHODS: From January 2002 to August 2007, 110 adult-to-adult LDLTs were performed in West China Hos- pital of Sichuan University. Among them, dual-graft implantations were performed in six patients. Sonographic findings of the patients were retrospectively reviewed. RESULTS: All the six recipients survived the dual-graft adult-to-adult LDLT surgery. All had pleural effusion. Four patients had episodes of postoperative abdominal complications, including fluid collection between the grafts in three patients, intrahepatic biliary dilatation in two, hepatofugal portal flow of the left lobe in two, and atrophy of the left lobe in one. CONCLUSION: Although dual-graft LDLT takes more efforts and is technically complicated, it is safely feasible. Postoperative sonographic monitoring of the recipient is important.

关键词： Liver transplantation Dual grafts Complications Ultrasonography

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