Medicine
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The Chinese government is attaching great importance to the development of ambulatory surgery in order to optimize the healthcare system in China. The study aims to examine the complications and quality indicators of patients who underwent gynecological ambulatory surgery at a tertiary hospital in China. This was a retrospective study of patients who underwent ambulatory surgery between July and September 2019 at the Department of Gynecology of the First Affiliated Hospital of Shandong First Medical University. ⋯ Compared with conventional hysteroscopic resection of uterine lesions, ambulatory hysteroscopic surgery had a shorter hospital stay and lower total costs (P < .05) but similar surgery-related costs. Ambulatory gynecological surgery is feasible in China, with an acceptable complication profile and obvious economic and social benefits. Nevertheless, hospital management shall be reinforced.
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This study aimed to examine whether marginal sinus placenta previa, defined as when the marginal sinus just reaches the internal cervical os and placental parenchyma might be >2 cm from the internal cervical os, can be diagnosed using ultrasonography (US). We identified the placenta previa cases that underwent both US and magnetic resonance imaging (MRI) between April 2010 and December 2018 at our institution. The diagnostic discrepancies for marginal sinus placenta previa between US and MRI were examined retrospectively. ⋯ A change in US diagnosis occurred in 10 (35.7%) cases, all of which were diagnosed with low-lying placenta previa or marginal placenta previa and did not develop any serious miserable obstetrical outcomes. In conclusion, the diagnostic accuracy of US for detecting marginal sinus placenta previa was not significant. MRI examination may be required to accurately categorize the types of placenta previa.
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Elastosonography is a non-invasive diagnostic method to evaluate tissue stiffness. The aim of our study was to demonstrate the applicability and efficacy of elastosonography to differentiate benign vs malignant subpleural lung lesions compared to clinical, radiological and histological findings. We performed both strain and shear wave velocity (SWV) elastosonography on subpleural lung lesions. ⋯ The ROC curve elaborated for the diagnosis of malignancy by strain elastography showed an AUC of 0.688. ROC curve for the diagnosis of malignancy by elasto index demonstrated an AUC of 0.802. SWV values obtained by ARFI elastosonographic method are higher in malignant lung lesions (mean SWV: 5.92 m/second) than in benign ones (mean SWV: 3.36); a composite score (elasto index) is characterized by better statistical significance for the differentiation of the lesions.
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To determine whether the change in the number of pulmonary ultrasound B-line can accurately assess the extravascular lung water (EVLW) before and after continuous bedside blood purification (CBP) in patients with multiple organ dysfunction syndrome (MODS). Seventy-six patients with MODS who underwent CBP were examined within 24 hours before and after CBP using pulmonary ultrasound to detect the number of ultrasound B-line or using pulse indicator continuous cardiac output method to examine extravascular lung water, blood oxygenation index, and B-type natriuretic peptide (BNP) content. The correlation of the change in the number of B lines before and after CBP treatment with the negative balance of 24 hours liquid, the change of oxygenation index, and BNP content were analyzed. ⋯ Correlation analysis showed that the decrease in B-line number after CBP treatment was positively correlated with the 24 hours negative lung fluid balance, decrease of EVLW, oxygenation index improvement, and decreased BNP content. The change in the numbers of pulmonary ultrasound B-line can accurately assess the change of EVLW before and after CBP treatment and reflect the efficiency of ventilation in the lungs and the risk of heart failure. Thus, it can replace pulse indicator continuous cardiac output as an indicator for evaluating EVLW in patients with MODS treated with CBP.
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Observational Study
Retrospective study of relationship between vastus medialis volume on SPECT-CT and outcome of unilateral total knee arthroplasty.
Although the importance of quadriceps femoris function was reported previously, little is known about volume-related factors and their effects on clinical outcomes after total knee arthroplasty (TKA). We sought to determine whether there was a bilateral difference in vastus medialis muscle volume measured on single-photon emission computed tomography-computed tomography (SPECT-CT) in patients who underwent unilateral TKA. We also aimed to determine whether vastus medialis volume was related to osteoarthritis (OA) severity or scintigraphic uptake degree around the knee joint on SPECT-CT. ⋯ However, a decreased vastus medialis muscle volume was related to worse clinical outcomes after TKA (P = .045), whereas the degree of scintigraphic uptake on SPECT-CT was not associated with postoperative clinical outcomes. Muscle volume of vastus medialis was decreased in the operated knee than in the nonoperated knee, and that was correlated with worse postoperative results. Even if the preoperative volume of vastus medialis were not related to OA severity on conventional radiographs and scintigraphic uptake on SPECT-CT, preservation and improvement of the muscle mass of the knee undergoing TKA is important.