Efficacy of prone positioning ventilation in acute respiratory distress syndrome after acute Stanford type A aortic dissection surgery / 中国胸心血管外科临床杂志

@#Objective     To explore the efficacy of prone positioning ventilation in patients with acute respiratory distress syndrome (ARDS) after acute Stanford type A aortic dissection (STAAD) surgery. Methods     From November 2019 to September 2021, patients with ARDS who was placed prone position after STAAD surgery in the Xiamen Cardiovascular Hospital of Xiamen University were collected. Data such as the changes of blood gas, respiratory mechanics and hemodynamic indexes before and after prone positioning, complications and prognosis were collected for statistical analysis. Results    A total of 264 STAAD patients had surgical treatment, of whom 40 patients with postoperative ARDS were placed prone position. There were 37 males and 3 females with an average age of 49.88±11.46 years. The oxygen partial pressure, oxygenation index and peripheral blood oxygen saturation 4 hours and 12 hours after the prone positioning, and 2 hours and 6 hours after the end of the prone positioning were significantly improved compared with those before prone positioning ventilation (P<0.05). The oxygenation index 2 hours after the end of prone positioning which was less than 131.42 mm Hg, indicated that the patient might need ventilation two or more times of prone position. Conclusion     Prone position ventilation for patients with moderate to severe ARDS after STAAD surgery is a safe and effective way to improve the oxygenation.

A Case of Successful Treatment of Infective Endocarditis Complicated with Intracranial Hemorrhage, and Literature Review.

The risks of neurological deteriorations during open heart surgery under heparinization in patients with infective endocarditis complicated by intracranial hemorrhage remain unknown. The optimal timing for heart surgery is still a point of conflict. We report a case in which a young man who had suffered from infective endocarditis complicated with intracranial hemorrhage successfully received mitral valve replacement on day 9 after the onset of intracranial hemorrhage.

In vivo imaging of colon mucosa targeted gadolinium-loaded chitosan particles in mice with MRI / 中华放射学杂志

Objective To synthesize a novel vector of chitosan-particles loaded with gadolinium (Gd-CPs) and observe the adhesion and absorption of the particles in the colon wall of mice with MR imaging in-vivo.Methods Chitosan particles (CPs) with and without gadolinium loaded were synthesized with the emulsion-droplet coalescence method.Sixteen mice were randomly classified into two groups.The suspension with Gd-CPs or with CPs was infused into the rectum of the 8 mice of each group,respectively.MR scans were performed before,during and 40 minutes after infusion for each mouse.Samples of the colon correlated to the enhanced area were obtained for electron microscopy examination.Signal intensity (SI) of ROIs in the wall of rectum or colon,muscles of the pelvis near the rectum and background were measured and corresponding relative SIs were calculated.Relative SI values between the two groups and pre- and post- infusion were compared with pared t test.Results Dimension of the Gd-CPs was about 500 nm,and content rate was about 30%. Values of relative SI of the rectum for pre- and post- infusion in the Gd-CPs group were 0.84±0.06 and 0.98±0.09(t=4.327,P＜0.01),respectively,while those in CPs group were 0.83±0.04 and 0.84±0.05(t=0.658.P＞0.05). The medial value of signal increase rate for CPs group was 19.0%.Gd-CPs particles were found inside the mucosal cells under the electron microscopy.Conclusion MR imaging in-vivo can reveal the phenomenon of adhesion and absorption of mucosa targeted chitosan particle carriers. Clinical MR imaging based on small animal coil is a good method to monitor colon mucosa targeted particle vectors in-vivo.

The Comparison of CT Angiography(CTA) and DSA in Neurovascular Disease / 实用放射学杂志

Objective To assess the value of CTA and DSA in neurovascular diseases.Methods 20 cases with suspected neurovascular disorders who received CTA and DSA examination between March 1999 and August 2000 were retrospectively collected.The sensitivity,specifility and accurate rate of CTA were analysed compared with DSA as gold standard.Results In 20 cases,neurovascular disorders were found in 17 on CTA.18 lesions were detected,including 6 aneurysms,9 arteriovenous malformations(AVM),2 carotid cavernous fistulae(CCFs)and 1 arterial stenosis.By contrast,19 lesions in 17 cases were detected by DSA,including 7 aneurysms,8 AVMs,2 arterial stenoses and 2 CCFs.The sensitivity,specificity and accuracy of CTA in the detection of neurovascular disorders were 90.6%,95.2% and 90.6% respectively.Conclusion 3D-CTA is a new modality with high sensitivity and specificity in the detection of neurovascular disorders.As it can be obtained simply,conveniently and safely with mild injury to the patient,CTA can be used in the diagnosis of neurovascular diseases,especially in the AVMs.

Value of Dynamic Spiral CT in Prostate Cancer and Benign Prostate Hyperplasia / 实用放射学杂志

Objective To detect the value of dynamic spiral CT on the prostatic cancer and benign prostate hyperplasia(BPH).Methods Plain and dynamic spiral CT scans were obtained in 88 male patients with various ages due to prostate or other pelvis diseases.Out of these detailed data in 5 cases of prostate cancer and 11 cases of BPH which were confirmed by operation and pathology were available.Contrast enhancement pattern and degree were correlated with the pathological and operational findings.Results Prostate was enlarged in all cases except one prostate cancer and 3 cases of BPH within normal limits in size.The contour of the prostate was irregular in all cancer cases and one BPH.On dynamic CT scans,prostatic malignant lesions appeared iso-hypodensity with the rest of the prostate gland at the arterial stage and low density at the veinous stage.Diffuse heterogeneous central enhancement was found in 10 cases of BPH at the arterial stage,especially in the lateral lobes and further enhancement was found in 10 cases of BPH at the arterial stage,especially in the lateral lobes and further enhancement was found at the middle stage.There was little enhancement in the peripheral part at the arterial and veinous stages in BPH.The ratio of the central and the peripheral decreased.One case of BPH within normal size had spotty enhancement in the central part.On delayed CT scans 8 cases of BPH showed homogeneous enhancement in the total prostate gland.Conclusion Prostate cancer and BPH have their own characteristic enhancement patterns and degress,therefore dynamic spiral CT scan could help make differentiation between the two disease.