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Affiliation between foods protection, diet regime good quality, as well as diet consumption while pregnant inside a predominantly Black gang of girls from New york.
Objective To examine the ultrasound features and clinical characteristics of the intestinal ischemia secondary to acute mesenteric venous thrombosis (AMVT). Methods From January 2016 to June 2019, 11 patients were diagnosed as intestinal ischemia secondary to AMVT confirmed by surgical pathology or CT in Peking Union Medical College Hospital. The patients included 7 males and 4 females, aging of (52.8±11.9) years (range 34 to 81 years).The clinical characters and ultrasound features were retrospectively reviewed. Brincidofovir Results Abdomen pain was the chief complaint of all patients. Other complaints include 2 cases of blood in the stool, 1 case of hematemesis, 2 cases of vomiting, 1 case of diarrhea. Six patients showed rebound pain on physical examination. All patients had elevated white blood cell account and D-Dimer. Nine patients had a thrombosis in the portal vein simultaneously. All 11 patients underwent the CT scan including 10 contrast-enhanced CT. Mesenteric venous thrombosis was detected in 10 cases who underwent contrast-enhanced CT imaging. On CT imaging, 11 patients demonstrated intestinal wall thicken, 5 patients showed intestinal dilation. Eight patients underwent superior mesenteric venous ultrasound examination. Of them, 7 patients were correctly diagnosed as AMVT. Of the 10 patients who underwent abdominal ultrasound, 5 patients showed intestinal lesions including intestinal wall thicken in 4 patients and intestinal dilation in 1 patient. Peritoneal fluid was detected in 10 patients by ultrasound, which was consistent with CT. Ten patients underwent surgical procedures while 1 patient received conservative treatment. Conclusion Ultrasound is an accurate imaging method in diagnosing superior mesenteric vein thrombosis and can detect intestinal wall thickening, intestinal dilation, and peritoneal fluid.Objective To examine the effect of the "four-steps" treatment on infectious pancreatic necrosis(IPN). Methods The data of 207 patients who were diagnosed with IPN from January 2013 to December 2017 at Department of Pancreaticobiliary Surgery, the First Affiliated Hospital of Harbin Medical University were analyzed retrospectively. Among 207 patients, 132(63.8%) were males and 75(36.2%) were females. The median age was 45 years old (range 19 to 80 years old). One hundred and fifty-eight patients(76.3%) suffered severe acute pancreatitis and 49 patients(23.7%) suffered moderately severe acute pancreatitis. Percutaneous catheter drainage(PCD) was performed on all the patients(Step 1). Patients received "four-steps" minimally invasive treatment strategy in step-up group(173 patients). The following steps after PCD were mini-incision access pancreatic necrosectomy(MIAPN) (Step 2), sinus tract endoscopic debridement and(or) PCD for residual infections(Step 3) and finally conventional open pancreatic necrosectomy(OPN operation time were significantly shorter in the step-up group(29(15) days vs. 36(17)days, Z=-0.567, P=0.008; 58(27)minutes vs. 90(56)minutes, Z=-3.908, P0.05). Fewer patients required ICU treatment after operation in the step-up group compared with OPN group(22.0% vs. 44.1%, χ(2)=6.204, P=0.013). Patients in the Step-up group has shorter hospital stay than patients in OPN group (46(13) days vs. 52(13)days, Z=-1.993, P=0.046). Conclusions The clinical effects of "four-steps" exhibited the superiority of minimally invasive treatment of IPN.And MIAPN is a simple, safe and effective procedure to remove pancreatic necrotic tissue and decrease complications.Objective To examine the outcomes of surgical repair for patients with total subclavian artery occlusion. Methods A retrospective analysis was performed on 67 patients with subclavian artery occlusion disease admitted at Ward 1 of Aortic and Vascular Surgery Center, Fuwai Hospital from January 2016 to July 2019. The age was, and There were 51 male patients and 16 females with an age of (61.7±8.2) years (range 37 to 79 years). The t-test, Mann-Whitney U-test, χ(2) test, and Fisher's exact test were used to analyze the factors related to the technique success. The Kaplan-Meier curve was used to calculate the cumulative patency rate and plot the corresponding survival curves, and the Log-rank test was used for comparison. The length from the subclavian artery ostial to the occlusion area was used as a variable to plot the receiver operating characteristic curve, and the optimal cut-off value was determined by the Youden index. Results Eighteen patients received open surgery. Forty-nine patients with subclavian acular treatment were 70.2% vs. 100% (P=0.048) at 24-month. No independent prognosis factors were identified through the Cox proportional risk model which significantly affected postoperative patency rates for patients with subclavian artery occlusion. Conclusions Part of patients with subclavian artery occlusion can be treated by endovascular therapy. The success rate of left subclavian artery occlusions is higher than right sides. The length from the subclavian artery ostial to the occlusion area affected the success rate of repair.Objectives To examine the prognosis factors for readmission after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) patients in the Chinese population. Methods A total of 1 129 AAA patients who underwent EVAR at Department of Vascular Surgery, Zhongshan Hospital, Fudan University, from January 2010 to December 2017 were enrolled. There were 948 males and 181 females, with an age of (71.2±9.6) years (range 18 to 93 years). Comorbidities included primary hypertension found in 630 patients, diabetes mellitus in 129 patients and coronary heart disease in 163 patients. A total of 214 patients had a history of smoking, and 11 patients had a history of previous aortic intervention.Clinical data including baseline information, laboratory examinations and follow-up data before December 31, 2019 were retrospectively collected. The primary end point was readmission. Cox regression analysis was used to analyze the prognosis factors for the end point. Results All patients completed at least one folloe-operative fibri nogen level was the risk factor for the survival time free from aortic-related readmission, though further researches were warranted for exploring the underlying mechanism.Objective To examine the mid- and long-term outcomes of endovascular aneurysm repair (EVAR). Methods This was a retrospective cohort study of 540 patients with abdominal aortic aneurysm who received EVAR at Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University from January 2009 to December 2018. There were 503 males and 37 females, aged of (69±8) years (range 44 to 87 years). Clinical data including concomitant disease, aneurysm size and surgical data were collected and patients were followed up after operation. The cumulative survival rate was assessed using the Kaplan-Meier estimator and multivariate Cox regression was used to analyze the independent prognosis factors. Results The technical success rate was 91.1% (492/540). The perioperative mortality rate was 1.3% (7/540) and the follow-up rate was 91.7% (489/533). The median follow-up time was 45(63) months (range 1 to 133 months). The all-cause mortality rate was 21.3% (104/489) and the aneurysm-related mortality rate was 6.3% (31/489) during follow-up period. The overall cumulative survival rate of 1-, 3-, 5- and 10-year were 95.1%, 84.0%, 69.5% and 38.6%, respectively, while freedom from aneurysm-related death were 98.4%, 93.3%, 88.4% and 84.4%. During the follow-up period, the complications rate was 9.0% (44/489), and the re-intervention rate was 4.9% (24/489). Cox regression analysis showed that elder age (HR=2.15, 95%CI 1.41 to 3.26, P less then 0.01), preoperative aneurysm rupture (HR=2.72, 95%CI 1.78 to 4.15, P less then 0.01) and short neck aneurysm (HR=1.97, 95%CI 1.07 to 3.61, P=0.029) were independent prognosis factors for long-term survival after EVAR. Connclusion EVAR has low perioperative mortality, high technical success rate, and satisfactory mid-and long-term outcomes.Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can speed up the regeneration of future liver remnant (FLR) in short period of time, and offer a chance for surgical resection for patients without sufficient FLR. However, ALPPS still remains controversy due to its high perioperative morbidity and mortality, as well as the uncertain long-term oncological benefits. How to solve these problems is the key to ensure the safety of surgery.This article focus on the indication selection, liver function reserve evaluation and timing to perform the second stage surgery, surgical mode evolution and comparison with portal venous embolization/portal venous ligation+two-stage hepatectomy.The rational clinical examination is important. The authors raised the concept of "medical imaging clinical appropriateness (MICA) " to meet the medical need in clinic (for diagnosis or assessment of a kind of disease or syndrome), which means radiologists and clinicians work together to carefully evaluate the necessity and rationality of an examination according to evidence of evidence-based medicine, expertise, experience, and patient's willing.The necessity is prerequisite, the rationality is the core, the evaluation of evidence is the basis, the application of evidence-based medicine is the important method. This work will provide us a series of criteria in the format of guidelines, providing evidence of rational examination for clinicians. Based on hard working and cooperation between radiologists and clinicians, we will establish the system of MICA in China, standardizing medical process, promoting rationalization, optimizing medical resources allocation and usage.In recent years, stent implantation has played an important role in solving femoropopliteal artery disease. Because part of the femoropopliteal artery is at the level of the knee joint, the deformation of this segment of the artery is greater when the lower limbs are bent, and the stent fracture rate is higher. Studies have showed that the deformation of the femoropopliteal artery mainly includes bending, twisting, axial compression and radial compression. The selection of stents with mechanical properties suitable for the deformation of artery in different sections can reduce the risk of fracture. The commonly used clinical stent designs (classic laser engraving stent, braided stent and covered stent) have large differences in mechanical properties. Braided stents with higher radial support are more suitable for treating popliteal artery disease, while covered stent has good compliance and can be used in all segments. Of course, the existing types of stents cannot meet all mechanical requirements. The design of the new stent needs to be studied, and its clinical results need to be confirmed by research.The bursa sac and greater omentum were considered as the dorsal mesogastrium more than 100 years. Bursectomy and omentectomy has been used as an essential part of radical gastrectomy with extended lymphadenectomy. However, structure of the bursa sac and omentum were difficult to be consistent with the definition and deduction of the mesentery. Also, it was hard to be proved that bursectomy and omentectomy could get oncological benefit from clinical randomized control trials recent years. We proposed a model of the proximal segment of dorsal mesogastrium (PSDM) here to compared with bursa model. It was demonstrated that the PSDM was consisted by the right gastric mesentery, right gastroepiploic mesentery, left gastric mesentery, left gastroepiploic mesentery, posterior gastric mesentery, and short gastric mesentery. The complete PSDM excision have been proved efficient in decreasing bleeding during operation and preventing cancer leak from PSDM during lymphadenectomy, as well as limiting the surgical hazard and developing oncological benefit.
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