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Objective@#The study is to assess the accuracy and reliability of three-dimensional simulated magnetic resonance imaging with silicone-excitation SPACE (sampling perfection with application optimized contrast using different flip angle evolutions) sequence for estimating implant volume.@*Methods@#(1) MRI examinations of 10 silicone implants (Wuhan Tongji Hospital from October 2018 to December 2018) were performed with T2, H2O-excitation SPACE sequence (T2-spc-H2O) and silicone-excitation SPACE sequence (T2-spc-Silicone) to find the most accurate method to estimate implant volume by ITK-SNAP. The effect of implant deformation and slice thickness of T2-spc-Silicone on volume measurement were investigated. (2) 13 normal patients and 6 patients with implant complications (Wuhan Tongji Hospital from March 2017 to May 2019) were enrolled for testing the accuracy and reliability of T2-spc-Silicone for volume measurement in vivo. The data were analyzed using Prism 8.0 software. The paired student t-test was used to compare the difference of two groups. One-way ANOVA was used to compare the difference of multiple groups. P<0.05 was considered statistically significant.@*Results@#The absolute volume differences of T2, T2-spc-H2O, T2-spc-Silicone were (42.19±2.31) ml, (23.27±1.55) ml and (6.28±1.22) ml. The absolute volume differences of T2-spc-Silicone group was significantly less than T2-spc-H2O and T2 group in vitro(F=195.3, P<0.001). No significant difference(F=1.36, P=0.22)was shown between the normality group and the deformation group for estimating the volume of implants with the slice thickness of SPACE increased from 0.5 mm×0.5 mm×0.5 mm to 5.0 mm×5.0 mm×5.0 mm. Besides, the slices thickness of SPACE from 0.5 mm×0.5 mm×0.5 mm to 5.0 mm×5.0 mm×5.0 mm did not significantly affect the accuracy of volume measurement of the implants in deformation state(F=1.22, P=0.29). The measurement error of SPACE was (8.82±0.99) ml in normal patients. Moreover, there was no significant difference between measured volume[(226.4±12.76)ml] and actual volume of implants[(225.9±11.94) ml](t=0.31, P=0.76)in patients with implant complications. The result showed excellent intraobserver reliability (ICC=0.997) and internal consistency ranged from 0.986 to 0.997 (P<0.001).@*Conclusions@#The method to measure implant volume by silicone-excitation SPACE sequence had desirable accuracy and reliability. The deformation of the implant and the slice thickness of the SPACE sequence did not exhibit a significant effect on the accuracy of volume measurement.
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Objective To explore the key points of surgical techniques in individualized breast augmentation via inframammary fold (IMF) incision.Methods Fifty-six patients of our department from March 2014 to March 2017 in this group were followed up for 3-18 months,with average 12 months.According to the patients' characteristics to determine the size and dimensions of the implant and the exact position of new IMF,via IMF incision we inserted an implant part under the pectoralis major muscle and part posterior to the breast after precisely stripping and forming the implant pocket,which were the dual-plane augmentation mammoplasty.Results Compared with traditional endoscope-assisted breast augmentation via axillary incision,the breast augmentation via inframammary fold incision was more accurate,the operation time was shortened by an average of one hour,the intraoperative hemorrhage decreased by about 20 ml on average,the postoperative drainage fluid was reduced by about 70 ml on average,the hospitalization time was shortened by about 3 days,the postoperative breast shape was naturally upright,and the incision was hidden at the new inframammary fold.No hematoma,infection,significant hypertrophic scar,capsule contracture and other complications were noted.Conclusions The individualized dual-plane augmentation mammoplasty via IMF incision can hide the incision in the inframammary fold.The operation under direct vision and no use of special equipments make it an ideal breast augmentation surgery.
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Objective To investigate the clinical effect and prevention of different artificial tears in dry eye after cataract phacoemulsification combined with intraocular lens implantation. Methods Totally 57 patients (57 eyes) with dry eye after phacoemulsification combined with intraocular lens implantation who were diagnosed with cataract in the Department of Ophthalmology in our hospital from October 2016 to October 2017 were randomly divided into 3 groups including sodium hyaluronate group, polyethylene glycol group and control group. All patients underwent phacoemulsi-fication combined with intraocular lens implantation. The control group was given conventional treatment after surgery. The other two groups were given sodium hyaluronate eye drops and polyethylene glycol eye drops on the basis of conventional treatment respectively. The dry eye symptom score, tear film rupture time, Schirmer I test, corneal fluorescein staining score before surgery, at 1 week, 1 month and 3 months after surgery were observed. The therapeutic effect was evaluated. Results In the three groups, the dry eye symptom score and corneal fluorescein staining score after surgery was lower than that before surgery, and the tear film rupture time and Schirmer I test after surgery increased compared with that before surgery. There was significant difference in the recovery of dry eye between the two groups and the control group, of which the sodium hyaluronate group recovered most significantly. Conclusion Cataract pha-coemulsification has an effect on the stability of tear film, which leads to postoperative dry eye. Artificial tear can be used for prevention and treatment. Sodium hyaluronate eye drops are more effective and worthy of clinical application.
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Patients with gastrointestinal diseases are more likely to exhibit malnutrition. Nutritional support is needed for those who are with malnutrition or at risk. Nutritional support can be categorized into enteral nutrition and parenteral nutrition. With the widely application of nutritional support,more and more attention has been paid on its role in gastrointestinal diseases. It not only can improve the nutritional status,but also can alleviate the clinical symptoms to some extent and improve prognosis,which makes it a kind of extremely important treatment modality for gastrointestinal diseases. In this article,the advances in study on nutritional support of gastrointestinal diseases were reviewed.
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Objective The clinical effect of phacoemulsification and intraocular lens implantation in the treatment of senile cataract.Methods120 cases of senile cataract patients in September 2014 ~2016 year in December in our hospital, were randomly divided into two groups: the observation group after phacoemulsification combined with intraocular lens implantation, the control group was treated with small incision non phacoemulsification extracapsular cataract extraction.In the comparison of two groups.ResultsAfter treatment, the observation group was 0.5~0.9 the proportion of 51.7%, visual acuity>1 the proportion of 6.7% were significantly higher than control group (P<0.05);the complication rate of observation group was 43.3% lower than the control group 61.7%, the difference was statistically significant (P<0.05).ConclusionPhacoemulsification combined with intraocular lens implantation in senile cataract patients can effectively improve patients' visual acuity, control the occurrence of complications, and the prognosis is good.
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Objective To explore surgical methods of removing polyacrylamide hydrogel (PAHG) and the right time of repairing the deformity of breast after removing PAHG.Methods We operated with endoscopy to remove PAHG through the lower mammary areolar incision.According to injection influence,we made the dicision whether to put the silicon gel prosthesis (hereafter referred to as prosthesis) simultaneously,and to fix the porsthesis,and to rebuild the imframammary fold of breast using biological repair membrane (hereafter referred to as membrane).Results In all 46 patients,39 patients' injection and their envelope were removed entirely.7 patients left part of the envelope because of its thin and wide characters.14 of them accepted prosthesis augmentation mammaplasty simultaneously and 5 of these accepted membrane repair.4 patients received prosthesis augmentation in stage Ⅱ.All patients' incision were primary healing.The incision scars were not obvious.1 patient with breast cancer suffered breast excision; 1 patient who received prosthesis and membrane simultaneously appeared prosthesis displacement after 3 months and fixed again.1 patient who received membrane appeared hydrops in residual cavity,and the membrane was removed finally.Conclusions This method with endoscopy through mammary areolae is necessary for cleaning PAHG entirely.We can use prosthesis to repair the deformity of breast after removing PAHG,and if necessary use membrane to fix the implant and rebuild the inframammary fold of the breast.
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Objective To investigate the effects of Xuebijing injection on the transcription factors GATA-3 and T-bet of rats after cardiopulmonary resuscitation (CPR). Method The rat models of CPR was made by using asphyxia method. Thirty SD rats were randomly (random number) divided into three groups at random: sham operation rats (B group), conventional CPR rats (C group) and Xuebijing (4 mL/kg) treated rats (D group). The levels of serum IL-12, IL-4, TNF-α and IFN-γ were measured by using ELISA. The expressions of T-bet and GATA-3 mRNA in serum were detected by RT-PCR. The analysis of variance was used to compare the means of different groups including t-test and Wilcoxon test. Results Compared with group B, the levels of serum IL-12, TNF-α and IFN-γ in group C and group D were significantly elevated after CPR for 6 hours (P<0.01). In group C, the expression of GATA-3 mRNA and GATA-3/T-bet decreased (both P < 0.05), while the expression of T-bet mRNA increased (P<0.01) after CPR for 6 hours. In group D, the expressions of GATA-3 mRNA and T-bet mRNA as well as GATA-3/T-bet increased after CPR for 6 hours. The levels of IL-12, IFN-γ and TNF-α in group D were lower than those in groupC (P<0.01). Compared with group C, the expression of GATA-3 mRNA and GATA-3/T-bet were significantly elevated and the expression of T-bet mRNA decreased in group D. ConclusionsThe transcription factors GATA-3 and T-bet may fail to get balance after CPR. The Xiebijing injectio can modulate the balance between GATA-3 and T-bet, and the levels of IL-12,IFN-γ and TNF-α.