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Objective:To compare and analyze the complications of end-to-side ileocolon anastomosis and trans-side-to-side anastomosis in laparoscopic assisted radical resection of right colon cancer.Methods:A total of 104 patients with right colon cancer who were treated in the same medical group from March 2018 to October 2019 in Department of General Surgery, the Affiliated Cancer Hospital of Zhengzhou University were selected as the research subjects. All patients were randomly divided into observation group and control group, each with 52 cases. The end-to-side ileocolon anastomosis was used in the observation group and trans-side ileocolon anastomosis in the control group. The operation time, anastomotic fistula, intestinal obstruction and anastomotic stenosis cases, the first time of postoperative exhaustion, and the time of defecation, etc. were counted in two groups of patients, and the occurrence of postoperative complications related to two different anastomosis methods were compared and analyzed. The software of SPSS22.0 was used to conduct statistical analysis, the counting data was expressed by n(%) and the measurement data was expressed as mean ± standard deviation. The comparison of the two groups was by independent sample t test, the comparison of count data was by χ2 test. Results:After the operation of the two groups of patients, there was no significant difference in operation time, first exhaust time, first defecation time and intraoperative blood loss between the observation group and the control group ( P>0.05). The total incidence of complications such as anastomotic fistula, anastomotic stenosis, anastomotic bleeding, and intestinal obstruction in the observation group after surgery was 3.84% (2/52), and the total incidence of complications in the control group was 15.38% (8/52). The two groups had statistical significance in total postoperative complications ( χ2=3.983, P=0.046). Conclusion:In laparoscopic-assisted radical colonectomy for right colon cancer, the choice of anastomosis based on ileocolonic anastomosis can reduce the incidence of postoperative complications and enable patients to obtain better treatment results, thus it can be given priority consideration.
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Alzheimer' s disease is the most common kind of dementia without effective treatment. Via early diagnosis, early intervention after diagnosis is the most effective way to handle this disease. However, the early diagnosis method remains to be studied. Neuroimaging data can provide a convenient measurement for the brain function and structure. Brain structure network is a good reflection of the fiber structural connectivity patterns between different brain cortical regions, which is the basis of brain's normal psychology function. In the paper, a brain structure network based on pattern recognition analysis was provided to realize an automatic diagnosis research of Alzheimer's disease and gray matter based on structure information. With the feature selection in pattern recognition, this method can provide the abnormal regions of brain structural network. The research in this paper analyzed the patterns of abnormal structural network in Alzheimer's disease from the aspects of connectivity and node, which was expected to provide updated information for the research about the pathological mechanism of Alzheimer's disease.
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Objective To explore the clinical value of mDIXON?Quant sequence in the quantitative evaluation of transfusion dependent patients with liver and pancreas iron deposition. Method Prospective collection of 34 transfusion dependent patients from December 2016 to May 2018 in Tianjin First Central Hospital who had not undergone iron chelation therapy was conducted in this study. According to the volume of blood transfusion,the subjects were divided into small amount of blood transfusion group (23 cases with blood transfusion of 2 000 to 5 000 ml within 3 years) and massive blood transfusion group (11 cases with blood transfusion of greater than 5 000 ml within 3 years). All patients underwent MR examinations using a Philips Ingenia 3.0 T MR scanner with multi?echo 3D?fast field echo (FFE) and 3D mDIXON?Quant protocols. For 3D multi?echo FFE images, the R2*(R2*=1/T2*) of liver and pancreas were calculated voxel by voxel. For mDIXON?Quant images,the dR2*(d R2*=1/dT2*),which was different from the R2*with 3D multi?echo FFE,was calculated within liver and pancreas voxel by voxel. Pearson correlation was performed to investigate the relationship between the R2*value and dR2*value of liver and pancreas in each group,and between the R2*(and dR2*) of liver and pancreas with the volume of blood transfusion. A paired ttest was used to compare the values of R2* and dR2* in the same patient. Results For small amount of blood transfusion group: liver and pancreas R2* and dR2* values were significantly correlated with the correlation coefficients of 0.993 and 0.962 respectively. There was no correlation between the value of liver and pancreas and the amount of blood transfusion (P>0.05). There was no significant difference in R2*and dR2*values in liver and pancreas (P>0.05). For massive blood transfusion group:when T2*was smaller than 1.8 ms, the SNR of T2*maps was lower than that of dT2*maps, and the noise seriously affects the T2*measurements. When T2*was greater than 1.8 ms:liver and pancreas R2*and dR2*values were significantly correlated with the correlation coefficients of 0.991 and 0.989 respectively. Liver R2* and dR2* value were correlated with the volume of blood transfusion with the correlation coefficients of 0.527 and 0.639 respectively. Pancreas R2* and dR2* value were correlated with the volume of blood transfusion with the correlation coefficients of 0.590 and 0.602 respectively. There was statistical difference in R2*value of liver and dR2*value in paired t test (P<0.05),but there was no significant difference in R2*value of pancreas and dR2* value of pancreas (P>0.05). Conclusions Both multi?echo 3D FFE and mDIXON?Quant sequences can be applied for the evaluation of organ iron deposition.The mDIXON?quant sequence has advantages in heavy liver and pancreatic iron quantification
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Objective To explore the indicators change of early renal injury in patients with chronic obstructive pulmonary disease (COPD) and its clinical significance.Methods Ninety cases of COPD including 45 cases with stable period of COPD,45 cases with acute exacerbation of COPD who received treatment in Baoshan Branch of Shanghai General Hospital from January 2014 to December 2014 were enrolled in this study.Meanwhile 45 cases of healthy subjects were collected as the control group.According to the extent of hypoxia,the COPD patients were divided into mild subgroups (60mmHg
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and indexes of the ROI which had significant difference between the groups. Results In the white matter regions, MD, D∥and D⊥in many regions of AD group were increased significantly than the control group, and the differences were statistically significant. MD and D ⊥ showed more abnormalities, including the SCC, PCB, and FWM. Meanwhile, MK, K∥and K⊥in many regions of AD were decreased, and the differences were statistically significant. K ⊥ showed more abnormalities, including the SCC, FWM and TWM. In the gray matter regions, MD, D∥and D⊥of hippocampal of the AD group were all increased than the control group. However, it showed that MK and K⊥of the thalamus in AD group were 0.99 ± 0.10, 1.00 ± 0.11, respectively, and both increased than the control group (the value of MK and K⊥were 0.90±0.06, 0.90±0.07, respectively), and the differences were statistically significant (t values was 3.31, 3.57 respectively, and both P values were<0.01). The indexes of different ROI had correlations with the MMSE scores. There were more regions in kurtosis indexes correlated with the MMSE scores than the diffusion indexes. The strongest correlation among the analyses was MK of the SCC (r=0.73, P<0.05). Conclusions This study based on DKI found the complex alterations aroused by microstructural changes were not only in the white matter but also the gray matter of the AD patients, especially the increased kurtosis of the thalamus, and this suggested that the microstructural complexity of it was increased. Moreover, it also suggested that indexes of DKI had varied sensitivity in detecting different diffusion alterations.
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Objective To investigate the difference of amplitude of low-frequency fluctuation (ALFF) and fraction of amplitude of low-frequency fluctuation(fALFF) between Alzheimer's disease (AD)patients and normal aging (NA) controls by voxel-based analysis.Methods Thirty-one AD patients and 44 NA controls were enrolled in the study.Blood oxygen level dependent functional (BOLD) EPI data were obtained during resting-state by using 32-channel head coil.Data were realigned,normalized and then smoothed with 8 mm FWHM kernel.Resting-state fMRI toolkit(version 1.6) was used to generate ALFF and fALFF images.Independent two sample t-test was performed with SPM5 to compare ALFF and fALFF of AD and NA controls.Pearson correlation analysis was performed to examine the relationship between MMSE score and ALFF,fALFF parameters.The significance level was set to be uncorrected O.001 on the voxel level and 0.05 on the cluster level.Results AD patients showed increased ALFF in left temporal lobe (0.492 ±0.119) and right cingulated cortex (0.434 ± 0.093) of AD patients,which were 0.443 ± 0.068 and 0.380 ±0.081 in NA controls (t =2.658,2.227,P ＜ 0.05).Decreased fALFF was found in bilateral posterior cingulate cortices (1.167 ± 0.203) and increased fALFF was found in bilateral temporal lobes (left 1.226 ±0.127,right 1.146 ±0.214) with left side dominance,which were 1.453 ±0.269,1.134 ±0.088,1.014 ± O.132 in NA controls (t =5.001,3.695,3.285,P ＜ 0.05).Bilateral temporal ALFF and fALFF correlated with MMSE positively (r =0.768—0.909,P ＜ 0.05) with left dominance.Conclusion AD patients showed increased resting-state functional MRI changes correlated with MMSE score in the temporal lobes with left dominance,which indicated left temporal lobe may be the best location for the observation of disease progression in AD patients.
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Objective To investigate the voxel-based correlation of mini-mental state examination(MMSE) score with apparent diffusion coefficients(ADC) and fractional anisotropy (FA) derived from diffusion tensor imaging(DTI) in the patients with Alzheimer disease. Methods 12 patients aged (70.0± 10.5) years and 16 normal control aged (66.5±6.7) years were enrolled in this study.DTI was performed based on sequence and 32-channel head coils.ADC and FA images were calculated and normalized to the same space and smoothed with 8 mm Gaussian Kernel. With statistical parameter mapping software SPM5 package,the independent two sample t-test with general linear model were performed to detect ADC and FA differences between AD patients and normal control.Correlation analysis was performed between MMSE score and FA or ADC. Results AD patients showed elevated ADC value and decreased FA value in bilateral temporal lobe and anterior cingulate,which was more pronounced in the left than in the right.There was elevation of ADC value but no FA decrease in bilateral posterior cingulate.The abnormal ADC area was larger than that of FA.There was negative correlation between MMSE score and ADC of the right hippocampus(r=-0.9474,P=0.0232) and a tendency towards positive correlation between MMSE score and FA of the right hippocampus(r=0.5414,P=0.5853). Conclusions ADC value may be more sensitive than FA value in DTI. Right temporal lobe microstructure involvement is less severe,but has a stronger relationship with neuropsyehological abnormality.
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Objective To evaluate the applications of magnetic resonance cholangiopancreatography (MRCP) after fat meal in the preoperative evaluation of biliary anatomy of living liver donors.Methods Fifty cases of the preoperative donors for living liver transplantation were included and all had the corresponding intraoperative cholangiography (IOC) information. The MRCP of the donors for living liver transplantation was performed before and after fat meal (two fried eggs). The visualization and diameter of the secondary bile duct were analyzed before and after the fat meal. The results of the biliary branching pattern by MRCP after fat meal were compared with the corresponding IOC results. The accuracy, sensitivity,specificity, positive predictive value and negative predictive value of MRCP after the fat meal in distinguishing normal and any type of variant biliary anatomy were calculated. Results In all cases,82% of the 50 cases in MRCP before the fat meal could meet the diagnosis needs of the preoperative evaluation,and 100% of the 50 cases in MRCP after the fat meal could meet the diagnosis needs. There was significant difference in the demonstration quality and diameter of the secondary bile duct in MRCP before and after the fat meal (P＜0. 05). MRCP showed accurate anatomy of the biliary system, using IOC as the reference standard, in 49(98%) subjects. The sensitivity, specificity, positive predictive value and negative predictive value of MRC in distinguishing normal and any type of variant biliary anatomy were 98%,94. 7%, 100%, 10% and 96. 9%,respectively. Conclusion The MRCP after fat meal can clearly demonstrate the secondary bile duct and perfectly meet the needs of the preoperative evaluation of the living liver transplantation. The MRCP after fat meal and routine MRCP should be considered complementary to one another in order to avoid complications in living liver transplantation donors.
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ObjectiveTo investigate the effects of early stage Alzheimer's disease(AD)on white matter(WM)integrity using diffusion tensor imaging(DTI)and its relationship with cognitive function decline.MethodsDTI was performed in 32 subjects,including 14 early AD patients and 18 elder controls(ON)with a 1.5 T MR scanner. Fractional anisotropy(FA)and mean diffusivity(-D)values were computed and compared for 9 regions of interest(ROI).Eight standard neuropsychological tests were performed and compared between AD and ON to evaluate basic cognitive capacities of AD.Correlation analysis was applied between FA,(-D) values and scores of neuropsychological tests for all subjects.ResultsFA significantly decreased in splenium of the corpus callosum and the posterior parietal-temporal region(S2),and D significantly increased in the splenium in AD patients(P＜0.05).AD patients showed lower scores compared with ON in all neuropsychological tests(P＜0.05).FA of the splenium and S2 positively correlated with several tests scores,while (-D) of multiple ROIs negatively correlated with several tests scores (P＜0.05).ConclusionsIn the early stage of AD,neuropathology has effect not only on cognitive function,but also on white matter structure,and they have strong relationship.AD patients show white matter changes in specific regions,which reflect loss in cortico-cortical connections.
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Objective To study the application of SLINKY technique in MRA of head and neck by comparison of four TOF MRA methods. Methods We obtained images on 21 patients and 5 volunteers with SLINKY on all the 26 cases, MOTSA on 18 cases, single volume on 16 cases, and 2D on 12 cases. Three experienced radiologists evaluated the images, unknowing which method the images were. The evaluations included clearness of vessel branches, smoothness of vascular wall, and vascular continuity. Signal-to-noise (SNR), contrast-to-noise (C/Ns), and scan time were measured. Results SLINKY displayed vessel branches better and had better smoothness of vascular wall and vascular continuity than the other three methods(P