August 2019, Volume 22,No.24 Abstracts(B)

 Animal Experimental Study of Acoustic Radiation Force Impulse Imaging in the Assessment of Liver Fibrosis Severity TONG Jin1,CAO Chunli1,MA Ting1,LIU Shanshan2,KANG Yanfei1,XU Lihong3,DU Tingting1,LI jun1*
1.Department of Function Examination,the First Affiliated Hospital of the Medical College,Shihezi University,Shihezi 832008,China
2.Department of General Surgery,the First Affiliated Hospital of the Medical College,Shihezi University,Shihezi 832008,China
3.Department of Gastroenterology,the First Affiliated Hospital of the Medical College,Shihezi University,Shihezi 832008,China
*Corresponding author:LI Jun,Associate chief physician;
【Abstract】 Background Hepatic fibrosis is a precancerous lesion of cirrhosis and hepatocellular carcinoma.Early treatment can delay the progress of fibrosis.At present,the main diagnostic methods of liver fibrosis include liver biopsy and serological markers,but each method has its own defects.Objective To evaluate the accuracy of acoustic radiation force impulse imaging(ARFI) in the determination of liver fibrosis severity in a rabbit model of liver fibrosis.Methods This experiment was conducted between April and October 2015.A total of 44 healthy New Zealand rabbits were selected and randomly divided into 2 groups,36 for the experimental group,and 8 for control group.The experimental group were subcutaneously injected with CCl4 with the initial dose of 0.3ml/kg,0.4ml/kg from the 4th week,and 0.5ml/kg from the fifth week,which was also the maintenance dose till the end of 16-week intervention.The control group received the same amount of normal saline.At the 4th,6th,8th,10th,12th,14th,16th weeks of intervention,3-6 rabbits in the experimental group were randomly selected to be examined by ARFI technology in vitro and in vivo liver tissue to obtain the stiffness parameters of transverse shear wave velocity(SWV,SWV1),respectively.After each examination,the rabbits were killed by air embolization,and.liver tissues were sampled.H&E and Masson's trichrome staining were used to determine the pathological stage of liver fibrosis.The diagnostic efficiency of the ARFI in liver fibrosis stages was evaluated according to the area under the curve(AUC) of the receiver operating characteristic curve(ROC).Results By the 16th week of intervention,the rabbit liver fibrosis models were successfully established at different stages.Pathological examination showed that the control group had normal results and there was no fibrosis.In the experimental group,rabbit models were successfully established in all cases except 4 deaths(6 in stage F1,10 in stage F2,8 in stage F3 and 8 in stage F4).The rate of successful models was 88.9%(32/36).The SWV and SWV1 of the control group were less than those of the rabbits with stage F1-F4 fibrosis in the experimental group(P<0.05).In the experimental group,the SWV and SWV1 successively increased with the severity of liver fibrosis(P<0.05).SWV1 was greater than SWV either in rabbits of the control group or in rabbits with stage F1-F4 fibrosis in the experimental group(P<0.05).The AUC of SWV for the diagnosis of stage ≥F2,≥F3,F4 liver fibrosis were 0.901,0.939,0.945,respectively(P<0.001).When the cut-off points of SWV were selected as 2.21m/s,2.29 m/s,2.36 m/s,the sensitivity were 80.8%,87.5%,87.5% and the specificity were 83.3%,87.5%,79.3%,respectively.The AUC of SWV1 in diagnosing stage ≥F2,≥F3,F4 liver fibrosis were 0.901,0.901,0.958,respectively(P<0.001).When the cut-off points of SWV1 were selected as 2.58 m/s,2.92 m/s,3.26 m/s,the sensitivity were 80.8%,81.3%,87.5%,and the specificity were 83.3%,87.5%,95.8%,respectively.Conclusion  ARFI may be used as an effective tool for the evaluation of liver fibrosis severity in rabbits.The AUC of ARFI parameters,SWV and SWV1,in the determination of liver fibrosis in rabbits was larger than 0.9,indicating high accuracy,so they may be used for the evaluation of liver fibrosis severity.
【Key words】 Liver cirrhosis;Models,animal;Rabbits;Elasticity imaging techniques;Diagnosis
Recent Advances in Internet-based Management of COPD YANG Zhenjiao1,CUI Miaoling2*,TAN Guirong1,BAI Jing3,ZHANG Xiaofang1
1.Guangxi Medical University,Nanning 530021,China
2.Department of Nursing,the First Hospital Affiliated to Guangxi Medical University,Nanning 530021,China
3.Respiratory Medicine,the First Hospital Affiliated to Guangxi Medical University,Nanning 530021,China
*Corresponding author:CUI Miaoling,Professor,Master supervisor;
【Abstract】 Chronic obstructive pulmonary disease(COPD) is one of the multiple chronic diseases with a high mortality in China,which seriously affects the quality of life in patients.The application of Internet technologies in healthcare delivery upgrades the traditional delivery patterns of medical services,realizing the family-hospital seamless connection in disease management.We reviewed the articles about the application forms and areas of the Internet technologies in COPD management,and analyzed the problems during the Internet-based management,with a view to providing a reference for COPD management in China.
【Key words】 Pulmonary disease,chronic obstructive; Disease management; Computer communication networks
Advances in the Diagnosis and Treatment of Functional Constipation WANG Dongdong,WU Xiangbai*
Department of Colorectal and Anal Surgery,the Second People's Hospital of Yichang/Three Gorges University Anorectal Disease Research Institute,Yichang 443000,China
*Correspongding author:WU Xiangbai,Professor,Cheif physician;
【Abstract】 Functional constipation(FC) is a disease with a high prevalence commonly encountered in clinical settings,which can seriously impair human physical and mental health.This article reviews the latest progress in the diagnosis and treatment of FC. It mainly includes that the exact etiology and pathogenesis of FC are not yet clear. The diagnosis of FC mainly depends on the symptoms of patients, and constipation caused by intestinal and systemic organic causes should be excluded.Clinical examination methods for FC usually include colorectal transit time measurement,anorectal manometry,balloon expulsion test,defecography and dynamic MRI defecography.The treatments mainly include general management,pharmacotherapy,biofeedback therapy,traditional Chinese medicine treatment,psychological treatment and surgical management.Pharmacotherapy plays a greater role in treating FC than other therapies.Surgical management is only used for those with very serious conditions and without response to medical treatment.Moreover,indicators for surgical intervention should be strictly assessed.Although the surgical intervention can be performed based on individual conditions,the incidence of postoperative complications is high.At the same time, this paper also introduces some new FC therapies which have been gradually applied in clinic in recent years, such as ssacral neuromodulation and fecal bacteria transplantation,and some clinical effects have been achieved. Therefore, this article aims to provide new ideas for the future treatment of FC.
【Key words】 Constipation;Syndrome differ pathogen fact;Diagnosis;Surgical treatment;Medical treatment


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