Publications by authors named "Bu-Lang Gao"

146 Publications

Normal diameters of abdominal aorta and common iliac artery in middle-aged and elderly Chinese Han people based on CTA.

Medicine (Baltimore) 2022 Aug;101(31):e30026

CT Room and Department of Cardiothoracic Surgery and Neurosurgery, Shijiazhuang Third Hospital, Shijiazhuang, Hebei Province, China.

To investigate the normal diameter of the abdominal aorta and common iliac arteries of the middle-aged and elderly people in China and the relationship of the diameters with age, sex, height, weight, body mass index (BMI), and body surface area (BSA). This retrospective study enrolled 625 patients including 380 males and 245 females aged 60.00 years (interquartile range 13.00 years). All clinical data and the diameters of the abdominal aorta and common iliac arteries were analyzed. The diameter of the abdominal aorta was 21.49 ± 2.49 mm at the proximal, 16.94 (interquartile range 2.39) mm at the middle, and 15.65 (interquartile range 2.90) mm at the distal segment. The diameter of the common iliac artery was 10.76 (interquartile range 1.99) mm at the right proximal, 10.41 (interquartile range 2.05) mm at the left proximal, 10.74 (interquartile range 2.25) mm at the right distal, and 10.67 (interquartile range 2.22) mm at the left distal segment. The height, weight, BSA, BMI, diameters of the proximal, middle and distal abdominal aorta as well as the proximal and distal left and right common iliac arteries were significantly higher in males than those in females (P < .001). Height, weight, BSA, and BMI were significantly (P < .001) positively correlated with the diameter of the abdominal aorta and common iliac artery at the proximal, middle, and distal segments. The middle and distal diameters of the abdominal aorta were significantly higher in males than those in females (P < .05). The diameter of the abdominal aorta at the proximal, middle, and distal segment as well as the diameter of the left and right common iliac artery at the distal segment were significantly (P < .05) increased with age. The normal values of the diameter of the abdominal aorta and common iliac arteries are suggested for the middle-aged and elderly Chinese people for clinical reference. The diameters are gender related and significantly positively correlated with BSA, height, weight, and BMI, which is beneficial for the diagnosis and treatment planning of relevant vascular diseases.
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http://dx.doi.org/10.1097/MD.0000000000030026DOI Listing
August 2022

Corrigendum: DWI Combined With Hepatobiliary Phase Enhanced Imaging Can Better Differentiate Cholangiocarcinoma From Atypical Liver Abscesses.

Front Oncol 2022 21;12:967385. Epub 2022 Jul 21.

Department of CT/MRI Room, Affiliated Hospital of Hebei University, and Key Laboratory of Cancer Radiotherapy and Chemotherapy Mechanism and Regulations, Baoding, China.

[This corrects the article DOI: 10.3389/fonc.2022.723089.].
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http://dx.doi.org/10.3389/fonc.2022.967385DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9351391PMC
July 2022

Effects of Online Psychological Crisis Intervention for Frontline Nurses in COVID-19 Pandemic.

Front Psychiatry 2022 12;13:937573. Epub 2022 Jul 12.

Henan Provincial People's Hospital, Zhengzhou, China.

Objective: The psychological problems of frontline nurses in COVID-19 prevention and control are very prominent, and targeted intervention is needed to alleviate them. This study was to assess the impact of online intervention programs on psychological crisis of anxiety, depression levels and physical symptoms among frontline nurses fighting the COVID-19 pandemic.

Methods: A three-stage online psychological crisis intervention program was established. The General Anxiety 7 (GAD-7) assessment, Patient Health Questionnaire-9 (PHQ-9), and the Self-rating Somatic Symptom Scale (SSS) were used to evaluate the effect of intervention on the day before entering isolation wards (Time 1), the first day after leaving the isolation ward (Time 2), and at the end of the intervention (Time 3).

Results: Sixty-two nurses completed the study, including 59 female (95.2%) and three male nurses (4.8%) with an age range of 23-49 (mean 33.37 ± 6.01). A significant ( < 0.01) difference existed in the scores of GAD-7, PHQ-9, and SSS at different intervention periods. The GAD-7 score was significantly ( < 0.001) lower at the end of quarantine period (time 3) than that before entering the isolation wards (time 1) or after leaving the isolation wards (time 2), the PHQ-9 score was significantly ( = 0.016) lower at the end of quarantine period (time 3) than that after leaving the isolation wards (time 2), and the SSS score was significantly ( < 0.001) lower at the end of quarantine period (time 3) than that before entering the isolation wards (time 1) or after leaving the isolation wards (time 2).

Conclusion: The three-stage online intervention program based on the psychological crisis can be effective in reducing negative emotions and somatic symptoms and improving the mental health of frontline nurses in prevention and control of the COVID-19 epidemic. It may provide an empirical basis for psychological crisis intervention of frontline medical staff when facing public health emergencies.
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http://dx.doi.org/10.3389/fpsyt.2022.937573DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9316614PMC
July 2022

Angiographic Characteristics of Cerebral Perfusion and Hemodynamics of the Bridging Artery After Surgical Treatment of Unilateral Moyamoya Disease.

Front Neurosci 2022 14;16:922482. Epub 2022 Jun 14.

Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.

Purpose: To investigate the characteristics of cerebral perfusion and hemodynamics of bypass grafting in the treatment of moyamoya disease (MMD) using the iFlow color-coded flow map in comparison with magnetic resonance imaging-perfusion-weighted imaging (MRI-PWI) and computational fluid dynamic (CFD) analysis.

Materials And Methods: Patients with MMD treated with bypass grafting who had undergone MRI PWI and digital subtraction angiography for iFlow color-coded map was retrospectively enrolled and CFD was performed for calculating the hemodynamic stresses around the bypass grafting.

Results: Forty-five patients with unilateral MMD treated with bypass surgery were enrolled. The bypass surgery was successful in all patients, with no severe neurological complications during the periprocedural period. Followed up for 4-12 months (median 5.5), the neurological function was good in all patients. The cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time to peak (TTP) were significantly ( < 0.05) improved in the middle cerebral artery distribution area on the surgical side before and after vascular bypass, and the difference of TTP (s) measured from the proximal bifurcation of common carotid artery to the confluence of sinus was also significant ( < 0.05). A significant ( < 0.05) positive correlation existed in the perfusion parameters between the iFlow blood perfusion and the MRI-PWI perfusion, with -value for TTP of 0.765 ( < 0.01). The iFlow color-coded blood flow map showed warm color changes on the diseased side, similar to those on the contralateral side. In CFD analysis, the hemodynamic stresses were all improved, in and around the bypass grafting and distal vessels, which were beneficial to blood flow entering distal arterial branches.

Conclusion: The iFlow color-coded flow map can be used to analyze cerebral perfusion after bypass grafting for MMD, similar to MRI-PWI, and CFD can be used to analyze the hemodynamics after bypass grafting, revealing improved hemodynamics to promote blood flow entering distal arteries.
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http://dx.doi.org/10.3389/fnins.2022.922482DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239480PMC
June 2022

Values of MRI Imaging Presentations in the Hepatobiliary Phase, DWI and T2WI Sequences in Predicting Pathological Grades of Intrahepatic Mass-Forming Cholangiocarcinoma.

Front Oncol 2022 7;12:867702. Epub 2022 Jun 7.

Computed Tomography (CT)/Magnetic Resonance Imaging (MRI) Room, Affiliated Hospital of Hebei University, Baoding, China.

Objective: To retrospectively investigate the value of various MRI image menifestations in the hepatobiliary phase (HBP), DWI and T2WI sequences in predicting the pathological grades of intrahepatic mass-forming cholangiocarcinoma (IMCC).

Materials And Methods: Forty-three patients of IMCCs confirmed by pathology were enrolled including 25 cases in well- or moderately-differentiated group and 18 cases in poorly-differentiated group. All patients underwent DWI, T2WI and HBP scan. The Chi square test was used to compare the differences in the general information. Logistic regression analysis was used to analyze the risk factors in predicting the pathological grade of IMCCs.

Results: The maximal diameter of the IMCC lesion was < 3 cm in 11 patients, between 3 cm and 6 cm in 15, and > 6 cm in 17. Sixteen cases had intrahepatic metastasis, including 5 in the well- or moderately-differentiated group and 11 in the poorly-differentiated group. Seventeen (39.5%) patients presented with target signs in the DWI sequence, including 9 in the well- or moderately-differentiated group and 8 in the poorly-differentiated group. Twenty (46.5%) patients presented with target signs in the T2WI sequence, including 8 in the well- or moderately-differentiated group and 12 in the poorly-differentiated group. Nineteen cases (54.3%) had a complete hypointense signal ring, including 13 in the well- or moderately-differentiated group and 6 in the poorly-differentiated group. Sixteen (45.7%) cases had an incomplete hypointense signal ring, including 5 in the well- or moderately-differentiated group and 11 in the poorly-differentiated group. The lesion size, intrahepatic metastasis, T2WI signal, and integrity of a hypointense signal ring in HBP were statistically significantly different between two gourps. T2WI signal, presence or non-presence of intrahepatic metastasis, and integrity of hypointense signal ring were the independent influencing factors for pathological grade of IMCC.

Conclusion: Target sign in T2WI sequence, presence of intrahepatic metastasis and an incomplete hypointense-signal ring in HBP are more likely to be present in poorly-differentiated IMCCs.
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http://dx.doi.org/10.3389/fonc.2022.867702DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9209728PMC
June 2022

Spinal sagittal alignment and postoperative adding-on in patients with adolescent idiopathic scoliosis after surgery.

Orthop Traumatol Surg Res 2022 Jun 14:103352. Epub 2022 Jun 14.

Department of Radiology, The Third Hospital of Hebei Medical University, 139, Ziqiang Road, Shijiazhuang 050051, Hebei Province, China.

Introduction: Surgery for patients with adolescent idiopathic scoliosis (AIS) may change spinal sagittal alignment, and postoperative adding-on may affect spinal sagittal balance after reconstruction. This study was to investigate the effect of surgery on spinal sagittal alignment and the relationship between postoperative adding-on and spinal sagittal balance in patients with AIS.

Hypothesis: The hypothesis of this study was that the effect of surgery on AIS was associated with recovery of the spinal sagittal plane and that presence of postoperative adding-on might affect the spinal sagittal balance. Materials and methods This retrospective study enrolled 22 patients who received surgical treatment. Clinical, imaging and follow-up data were analyzed.

Results: After surgery, T1 slope (T1S) and thoracic kyphosis (TK) were significantly (P<0.05) lower in patients with postoperative adding-on (16.73°±6.12° for T1S and 28.95°±11.3° for TK) than those without adding-on (24.82°±8.59° for T1S and 40.29°±12.08° for TK). At the last follow-up, cervical lordosis (CL), T1S, and TK were significantly (P<0.05) lower in patients with adding-on (3.05°±11.41° for CL, 22.12°±3.68° for T1S, and 37.89°±8.97° for TK) than those without adding-on (15.94°±°13.6 for CL, 28.86°±4.26° for T1S, and 47.64°±7.1° for TK). The Cobb angle was significantly (19.65°±8.69° vs. 50.66°±11.46°; P<0.001) decreased after compared with that before surgery. At the final follow-up, the Cobb angle (26.48°±9.61° vs. 19.65°±8.69°, P<0.001), T1S (24.87°±5.11° vs. 20.04°±8.13°), and TK (41.88°±9.45° vs 33.53°±12.71°) all significantly (P<0.01) increased compared with those immediately after surgery. The Cobb angle significantly (26.48°±9.61° vs. 50.66°±11.46°, P<0.001) decreased while CL, T1S, and TK all significantly (8.32°±13.67° vs 2.47°±14.42° for CL, T1S 24.87°±5.11° vs. 21.28°±5.88° for T1S, and 41.88°±9.45° vs. 33.13°±10.97° for TK, P<0.05) increased at the final follow-up compared with those before surgery.

Discussion: Surgery affects spinal sagittal alignment, and postoperative adding-on may affect spinal sagittal balance after reconstruction. Surgery as the ultimate approach for AIS has good effects but may result in some side effects.

Level Of Proof: III, retrospective cohort study.
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http://dx.doi.org/10.1016/j.otsr.2022.103352DOI Listing
June 2022

Small Unruptured Intracranial Aneurysms Can Be Effectively Treated With Flow-Diverting Devices.

Front Neurol 2022 30;13:913653. Epub 2022 May 30.

Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.

Purpose: To investigate the effect and safety of flow diverters in the management of small (<10 mm in diameter) unruptured intracranial aneurysms.

Materials And Methods: One hundred and ten patients with 145 small intracranial aneurysms treated with flow diverters were retrospectively enrolled. The clinical, endovascular, and follow-up data were analyzed.

Results: One hundred twenty-one flow diverters were deployed for the treatment of 145 small intracranial aneurysms in 110 patients, and the stenting success rate was 99.1%. In 133 (91.7%) aneurysms, only flow-diverting devices were deployed, and in the rest 12 (8.3%) of aneurysms, coils were used to loosely pack the aneurysm after deployment of a flow-diverting device. Five patients (4.5%) experienced ischemic complications, but no hemorrhagic complications were occurred. All patients had clinical follow-up 6-18 (median 12) after the procedure, with the modified Rankin scale score (mRS) 0 in 101 patients, 1 in four patients, 2 in three patients, 4 in one patient, and 5 in one patient. Digital subtraction angiography was performed at follow-up in 90 (81.8%) patients with 118 (81.4%) aneurysms 6-18 months (median 12) after the procedure, with the Raymond grade I in 90 (76.2%) aneurysms and Raymond grade III in 28 (23.7%). Eighteen patients with 22 partially occluded aneurysms at the first angiographic follow-up experienced the second digital subtraction angiography 12-36 months (median 26) after the procedure, and 21 (95.5%) aneurysms were completely occluded. Two patients had asymptomatic in-stent stenosis.

Conclusion: Treatment of small unruptured intracranial aneurysms with flow diverters can be performed safely and effectively with satisfactory outcomes.
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http://dx.doi.org/10.3389/fneur.2022.913653DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9190436PMC
May 2022

Factors affecting clinical pregnancy in controlled ovarian hyperstimulation with GnRH-a long protocol: a retrospective cross-sectional study.

J Obstet Gynaecol 2022 Jun 9:1-6. Epub 2022 Jun 9.

Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

This retrospective cross-sectional study was to investigate factors affecting clinical pregnancy in patients who received gonadotropin-releasing hormone agonist luteal phase long protocol (GnRH-a long protocol) and underwent fresh fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) embryo transfer cycle. One thousand five hundred and twenty-five patients who received GnRH-a long protocol and underwent fresh IVF/ICSI embryo transfer cycle were enrolled. The clinical pregnancy rate (63.1 22.4%,  < .05) and live birth rate (53.8 14.5%,  < .05) were significantly higher while the miscarriage rate (12.5 35.3%,  < .05) was significantly lower in the two embryo group than those in the one embryo group. The clinical pregnancy rate (48.5 64.1%,  < .05) and live birth rate (38.4 55.0%,  < .05) were significantly lower in patients older than 33.5 years than those in younger patients. The clinical pregnancy rate (52 and 60.6 79.7%,  < .05) and live birth rate (36 and 51.4 69.6%,  < .05) of the thin and mediate groups were significantly lower than those in the thick group, whereas the ectopic pregnancy rate (11.5 and 1.9 0%,  < .05) was significantly higher in the thin group than in the mediate and thick group. Multivariate logistic regression analysis showed that age (OR = 0.956, 95% CI [0.931, 0.982],  < .05), number of embryos transferred (OR = 2.491, 95% CI [1.670, 3.715],  < .05) and endometrial thickness on the transplantation day (OR = 1.124, 95% CI [1.067, 1.185],  < .05) were independent factors significantly associated with clinical pregnancy. In conclusion, endometrial thickness (>14.69 mm) on the day of transfer, two cleavage embryos transferred, and female age (≤33.5 years) are independent factors affecting clinical pregnancy outcomes in controlled ovarian hyperstimulation with GnRH-a long protocol for assisted conception. IMPACT STATEMENT Fresh embryo transfer cycle with GnRH-a long protocol will result in a higher pregnancy rate in controlled ovarian hyperstimulation cycles. Endometrial thickness on the day of transfer, number of embryos transferred, and female age were independent factors affecting clinical pregnancy outcomes. When performing a fresh IVF/ICSI embryo transfer cycle with GnRH-a long protocol for ovulation induction, the independent affecting factors should be taken into consideration.
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http://dx.doi.org/10.1080/01443615.2022.2081490DOI Listing
June 2022

Sagittal morphology of the cervical spine in adolescent idiopathic scoliosis: a retrospective case-control study.

Quant Imaging Med Surg 2022 Jun;12(6):3049-3060

Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.

Background: To investigate the relationship between sagittal alignment and coronal deformity in patients with adolescent idiopathic scoliosis (AIS) through analysis of the spinal imaging data.

Methods: Four hundred and fifty-four AIS patients who underwent anteroposterior and lateral radiography of the while spine were enrolled, and the spinal parameters of Cobb angle, cervical lordosis, C1-C2 angle, T1 slope, thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt (PT), pelvic incidence (PI), cervical sagittal vertical axis (SVA), and spinal SVA were analyzed.

Results: The patients were divided into two groups according to the size of the Cobb angle: group A (Cobb angle ≤45°, n=414) and group B (Cobb angle >45°, n=40). In group A, the Cobb angle was in a medium negative correlation with the cervical lordosis angle (r=-0.637, P<0.001), a weak positive correlation (|r|<0.3, P<0.05) with C1-C2 angle, T1 slope and thoracic kyphosis. In group B, the Cobb angle was in a mild positive correlation (P<0.05) with PT (r=0.398) and PI (r=0.360). The cervical lordosis angle was significantly (P<0.05) different between male and female patients in both groups. In Group A, the cervical lordosis angle was in a significantly (P<0.01) positive correlation with the T1 slope (r=0.586), thoracic kyphosis (r=0.490), and sagittal vertical axis (r=0.135), and a significantly (P<0.01) negative correlation with cervical sagittal vertical axis (r=-0.128) and C1-C2 angle (r=-0.155). In group B, the cervical lordosis angle was in a significantly (P<0.05) positive correlation with T1 slope (r=0.661), thoracic kyphosis (r=0.608), lumbar lordosis (r=0.425), sacral slope (r=0.434), and sagittal vertical axis (r=0.335).

Conclusions: In AIS patients with the Cobb angle ≤45º, a significant negative correlation exists between the cervical lordosis and the Cobb angle. The sagittal morphology of the cervical spine in AIS patients is affected by the spinal coronal deformity, which plays an important role in the treatment of AIS.
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http://dx.doi.org/10.21037/qims-21-902DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9131346PMC
June 2022

DWI Combined With Hepatobiliary-Phase Enhanced Imaging Can Better Differentiate Cholangiocarcinoma From Atypical Liver Abscesses.

Front Oncol 2022 13;12:723089. Epub 2022 May 13.

Department of CT/MRI Room, Affiliated Hospital of Hebei University, and Key Laboratory of Cancer Radiotherapy and Chemotherapy Mechanism and Regulations, Baoding, China.

Objective: To investigate the value of diffusion-weighted imaging (DWI) combined with the hepatobiliary phase (HBP) Gd-BOPTA enhancement in differentiating intrahepatic mass-forming cholangiocarcinoma (IMCC) from atypical liver abscess.

Materials And Methods: A retrospective analysis was performed on 43 patients with IMCCs (IMCC group) and 25 patients with atypical liver abscesses (liver abscess group). The DWI signal, the absolute value of the contrast noise ratio (│CNR│) at the HBP, and visibility were analyzed.

Results: A relatively high DWI signal and a relatively high peripheral signal were presented in 29 patients (67.5%) in the IMCC group, and a relatively high DWI signal was displayed in 15 patients (60.0%) in the atypical abscess group with a relatively high peripheral signal in only one (6.7%) patient and a relatively high central signal in 14 (93.3%, 14/15). A significant (P<0.001) difference existed in the pattern of signal between the two groups of patients. On T2WI, IMCC was mainly manifested by homogeneous signal (53.5%), whereas atypical liver abscesses were mainly manifested by heterogeneous signal and relatively high central signal (32%, and 64%), with a significant difference (<0.001) in T2WI imaging presentation between the two groups. On the HBP imaging, there was a statistically significant difference in peripheral │CNR│ (< 0.001) and visibility between two groups. The sensitivity of the HBP imaging was significantly (=0.002) higher than that of DWI. The sensitivity and accuracy of DWI combined with enhanced HBP imaging were significantly (=0.002 and <0.001) higher than those of either HBP imaging or DWI alone.

Conclusion: Intrahepatic mass-forming cholangiocarcinoma and atypical liver abscesses exhibit different imaging signals, and combination of DWI and hepatobiliary-phase enhanced imaging has higher sensitivity and accuracy than either technique in differentiating intrahepatic mass-forming cholangiocarcinoma from atypical liver abscesses.
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http://dx.doi.org/10.3389/fonc.2022.723089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9137181PMC
May 2022

Accuracy of Calf Circumference Measurement, SARC-F Questionnaire, and Ishii's Score for Screening Stroke-Related Sarcopenia.

Front Neurol 2022 29;13:880907. Epub 2022 Apr 29.

Medical Imaging Department, First Affiliated Hospital of Kunming Medical University, Kunming, China.

Objective: The purpose of this study was to investigate the accuracy of sarcopenia diagnosis in patients with stroke using calf circumference (CC), SARC-F questionnaire, and Ishii's score in comparison with the Asian Working Group for Sarcopenia 2019 (AWGS) sarcopenia diagnostic criteria.

Materials And Methods: In this cross-sectional study, a total of 364 consecutive patients with stroke were enrolled and evaluated with the CC measurement, SARC-F questionnaire, and Ishii's score. The diagnostic accuracy was analyzed.

Results: Based on the AWGS criteria, sarcopenia was present in 180 (49.5%) patients, with an age range of 49-74 (mean 63 ± 14.7) years. In all patients, the cutoff value of CC in the accuracy of diagnosing sarcopenia was 30.5 cm, with an AUC of 0.85, sensitivity of 81.8%, specificity of 90.1%, Kappa value of 0.72, and Youden index of 0.72. In the accuracy of diagnosing sarcopenia in all patients, Ishii's score had a cutoff value of 118, AUC of 0.78, sensitivity of 90.1%, specificity of 36.0%, Kappa value of 0.4, and Youden index of 0.55. For accuracy of diagnosing sarcopenia, the SARC-F questionnaire had a cutoff value of 5, AUC of 0.731, sensitivity of 94.7%, specificity of 40%, Kappa value of 0.34, and Youden index of 0.41.

Conclusions: Based on the AWGS criteria, calf circumference measurement has the optimal performance in screening stroke-related sarcopenia compared with the SARC-F questionnaire and Ishii's score. In patients with stroke, the cutoff value of calf circumference for sarcopenia is < 31 cm in men and 30 cm in women, and with an AUC of 0.85.
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http://dx.doi.org/10.3389/fneur.2022.880907DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099210PMC
April 2022

Thoracolaparoscopic esophagectomy for esophageal cancer with a cervical incision to extract specimen.

Asian J Surg 2022 May 4. Epub 2022 May 4.

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.

Background: Surgical treatment is the most important and effective therapy for resectable esophageal cancer. Minimally invasive esophagectomy (MIE) can reduce surgical trauma. A neck incision can be performed for extraction of surgical specimen. This study was performed to investigate the safety and feasibility of neck incision to extract surgical specimen in thoracolaparoscopic esophagectomy for esophageal cancer.

Materials And Methods: Thirty-four patients who experienced thoracolaparoscopic esophagectomy for esophageal cancer and a neck incision for extraction of surgical specimen were enrolled. The clinical, surgical and follow-up data were analyzed.

Results: The procedure was successful in all patients (100%), with a neck incision to extract the surgical specimen. The median surgical time was 309 min, and the median blood loss was 186 ml, with the mean length of hospital stay of 11.5 days. Pulmonary complications occurred in 8 patients (23.5%). Anastomotic leakage occurred in 5 patients (14.7%), with one patient being treated conservatively to recover and four (11.8%) who received interventional drainage. One patient with interventional drainage died of severe infection, resulting in a 30-day surgical mortality of 2.9% (n = 1). Gastrointestinal complications happened in 5 patients (14.7%), including ileus in three patients and anastomotic stenosis in two patients. Follow-up was performed at a median time of 20 months (interquartile range, 14-32 months), with no death during this period. No recurrence was found in the first 12 months after radical resection.

Conclusion: The cervical incision to extract surgical specimen is safe and feasible with improved cosmetic effect in thoracolaparoscopic esophagectomy for esophageal cancer.
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http://dx.doi.org/10.1016/j.asjsur.2022.04.073DOI Listing
May 2022

Clinical and Imaging Features of Desmoplastic Fibroma of Bone for Correct Diagnosis and Differentiation.

Curr Med Imaging 2022 04 11. Epub 2022 Apr 11.

Department of Radiology, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China.

Objective: To analyze the clinical and imaging features of desmoplastic fibroma of bone (DFB) for correct diagnosis.

Materials And Methods: Twenty patients with DFB confirmed by pathology were enrolled, and the imaging presentations were analyzed. Among 20 patients, plain X-ray was performed in all patients, computed tomography (CT) was performed in 12, and magnetic resonance imaging (MRI) was conducted in eight. The clinical and imaging presentations were analyzed and classified to assist correct diagnosis.

Results: Twenty patients with DFB were retrieved including eleven males and nine females with an age range of 2-52 years (median 27). The DFB involved the femur in six patients, ilium in five, tibia in four, humerus in two, lumbar vertebra in one, radius in one, and calcaneus in the remaining one. DFB was common in the metaphysis of long bones could involve the diaphysis and epiphysis. The imaging presentations were divided into four types: the cystic expansile destruction in ten patients, osteolytic destruction in five, mixed destruction in four, and paraosseous destruction in one. CT value was 30 -60 Hu in the lesion area (6 cases CT value>45Hu). In eight patients with MRI scanning, the lesion in five patients presented with unevenly equal or low signal on T1WI and unevenly equal or high signal on T2WI, with irregular stripes or patches of low signal on both T1WI and T2WI. In the rest three patients, the lesion was evenly equal or low signal on T1WI and evenly high signal on T2WI. MRI more clearly showed a mass in the adjacent soft tissue and the range of edema in the DFB lesion. Conclusion DFB is a rare tumor with strong local aggressiveness, cystic bone destruction, formation of tumor bone trabeculae, soft tissue masses on imaging presentations, low signals on T1WI and T2WI in the lesion, but no periosteal reaction or calcification, which are helpful for diagnosis of the disease and differentiation from other ones.
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http://dx.doi.org/10.2174/1573405618666220411125408DOI Listing
April 2022

Impact of Elevated Progesterone in Late Follicular Phase on Early Pregnancy Outcomes and Live Birth Rate After Fresh Embryo Transfers.

Front Cell Dev Biol 2022 11;10:855455. Epub 2022 Mar 11.

Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China.

To investigate the effect of progesterone elevation during late follicular phase on early pregnancy outcomes and live births after fresh embryo transfers. Patients who underwent IVF/ICSI treatment cycles were retrospectively enrolled. The effect of progesterone elevation was analyzed on early pregnancy outcome and live births after fresh embryo transfers. A total of 2,404 patients were enrolled on the day of HCG triggering (HCG0), 1,584 patients on the day before HCG triggering (HCG-1), and 800 patients 2 days before HCG triggering (HCG-2). With a 1 ng/ml increase in the progesterone level on HCG0 day when the progesterone level was ≥1.5 ng/ml, the clinical pregnancy rate decreased by 60% (95% CI: 0.2-0.7, = 0.004), the intrauterine pregnancy rate decreased by 70% (95% CI: 0.2-0.7, = 0.003), and the live birth rate decreased by 70% (95% CI: 0.1-0.7, = 0.004). With a 1 ng/ml increase in the progesterone level on HCG-1 day, the clinical pregnancy rate decreased by 90% (95% CI: 0.0-0.5, = 0.003) when the progesterone level was ≥1.6 ng/ml, the intrauterine pregnancy rate decreased by 90% (95% CI: 0.0-0.5, = 0.001) when the progesterone was ≥1.5 ng/ml, and the live birth rate decreased by 90% (95% CI: 0.0-0.6, = 0.015) when the progesterone was ≥1.7 ng/ml. On HCG-2 day when the progesterone was ≥1.2 ng/ml, the clinical pregnancy rate decreased by 80% (95% CI: 0.1-0.6, = 0.003), and the intrauterine pregnancy rate decreased by 70% (95% CI: 0.1-0.7, = 0.007) with a 1 ng/ml increase in the progesterone level. Elevated progesterone level during the late follicular phase is an independent risk factor affecting the clinical pregnancy rate, intrauterine pregnancy rate, and live birth rate among infertile patients undergoing IVF/ICSI after fresh embryo transfers. When the progesterone level exceeds a certain level, the early pregnancy and live birth rates after fresh embryo transfers show a rapid downward trend.
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http://dx.doi.org/10.3389/fcell.2022.855455DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8965638PMC
March 2022

Cerebral aneurysms at major arterial bifurcations are associated with the arterial branch forming a smaller angle with the parent artery.

Sci Rep 2022 03 24;12(1):5106. Epub 2022 Mar 24.

Department of Medical Research and Neurosurgery, Shijiazhuang People's Hospital, 9 Fangbei Road, Shijiazhuang, 050011, Hebei, China.

Currently, the relationship of bifurcation morphology and aneurysm presence at the major cerebral bifurcations is not clear. This study was to investigate cerebral arterial bifurcation morphology and accompanied hemodynamic stresses associated with cerebral aneurysm presence at major cerebral arterial bifurcations. Cerebral angiographic data of major cerebral artery bifurcations of 554 anterior cerebral arteries, 582 internal carotid arteries, 793 middle cerebral arteries and 195 basilar arteries were used for measurement of arterial diameter, lateral and bifurcation angles and aneurysm deviation. Hemodynamic stresses were analyzed using computational fluid dynamic simulation. Significantly (P < 0.001) more aneurysms deviated toward the smaller branch and the smaller lateral angle than towards the larger branch and larger lateral angle at all four major bifurcations. At the flow direct impinging center, the total pressure was the greatest while the dynamic pressure, wall shear stress (WSS), vorticity and strain rate were the least. Peak 1 and Peak 2 were located on the branch forming a smaller and larger angle with the parent artery, respectively. The dynamic pressure (175.4 ± 18.6 vs. 89.9 ± 7.6 Pa), WSS (28.9 ± 7.4 vs. 15.7 ± 5.3 Pa), vorticity (9874.6 ± 973.4 vs. 7237.8 ± 372.7 1/S), strain rate (9873.1 ± 625.6 vs. 7648.3 ± 472.5 1/S) and distance (1.9 ± 0.8 vs. 1.3 ± 0.3 mm) between the peak site and direct flow impinging center were significantly greater at Peak 1 than at Peak 2 (P < 0.05 or P < 0.01). Moreover, aneurysms deviation and Peak 1 were always on the same side. In conclusion, the branch forming a smaller angle with the parent artery is associated with abnormally enhanced hemodynamic stresses to initiate an aneurysm at the bifurcation apex.
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http://dx.doi.org/10.1038/s41598-022-09000-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8948358PMC
March 2022

En bloc mesoesophageal esophagectomy through thoracoscopy combined with laparoscopy based on the mesoesophageal theory.

Surg Endosc 2022 Aug 11;36(8):5784-5793. Epub 2022 Mar 11.

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China.

Purpose: To investigate the effectiveness and clinical significance of thoracolaparoscopic esophagectomy with mesoesophagus excision.

Materials And Methods: Patients who underwent en bloc mesoesophageal esophagectomy through thoracoscopy combined with laparoscopy were retrospectively enrolled. Carbon nanoparticles were used in some patients to label the esophageal drainage lymph nodes. The clinical data were analyzed.

Results: En bloc mesoesophageal esophagectomy was successfully performed in 135 patients (100%). The carbon nanoparticles were used in 10 patients, among which the left gastric arterial lymph nodes were labeled in all patients and excised together with the left gastric mesentery, mesoesophagus, esophageal cancer, lymph nodes, vessels, nerves, and adipose tissues as one intact package. The mean operation time was 182.5 ± 26.4 min, intraoperative blood loss 45.9 ± 17.6 ml, mean number of lymph nodes dissected 20.9 ± 8.12, extubation time of drainage tubes 7.5 ± 3.8 days, first oral feeding time 7.5 ± 1.8 days, and postoperative hospital stay 13 ± 5.11 days. Postoperatively, anastomotic leakage occurred in six patients (4.4%), anastomotic stenosis in eight (5.9%), hoarseness in seven (5.2%), and inflammation of the remnant stomach in four (3.0%), with a complication rate of 18.5%. Patients were followed up for 13-34 months (median 23). Eighteen patients presented with organ metastasis. No local recurrence or death during follow-up.

Conclusion: Based on the membrane anatomy or mesoesophagus theory, thoracolaparoscopic en bloc mesoesophageal esophagectomy is safe, with decreased blood loss, and it is necessary to resect the left gastric artery lymph nodes together with the left gastric mesentery and its contents to completely remove the cancer.
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http://dx.doi.org/10.1007/s00464-022-09175-0DOI Listing
August 2022

Diagnosis of diffuse parenchymal lung diseases using transbronchial cryobiopsy guided by endobronchial ultrasound compared to clinicoradiological diagnosis.

Quant Imaging Med Surg 2022 Feb;12(2):1139-1148

Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou, China.

Background: This study aimed to evaluate the safety and effect of transbronchial cryobiopsy guided by radial probe endobronchial ultrasound (RP-EBUS) compared with clinicoradiological diagnoses in diffuse parenchymal lung diseases (DPLDs).

Methods: A total of 60 patients with DPLDs confirmed by chest computed tomography (CT) who underwent transbronchial lung cryobiopsy guided by RP-EBUS were enrolled. The ultrasound images were obtained and identified together with corresponding chest CT characteristics. The cryobiopsy samples were evaluated histopathologically and compared with CT imaging, and the complications were analyzed.

Results: The multidisciplinary diagnosis was clear in 51 (85%) participants but unclear in the remaining 9 (15%) participants. In transbronchial cryobiopsy guided by RP-EBUS, 36 (60%) participants had the biopsy in 1 lobe while 24 (40%) had a biopsy in 2 different lobes, with a mean biopsy specimen size of 43.17±15.25 mm. The histopathologic diagnosis based on biopsy confirmed the preprocedural clinicoradiological diagnosis in 51 (85%) patients and clarified the diagnosis in the other 9 patients with unclear clinicoradiological diagnosis, including alveolated lung parenchyma with interstitial chronic inflammation in 4 (6.7%) cases and chronic bronchiolitis and interstitial lymphocytic infiltrates in the other 5 (8.3%). Intraprocedural complications occurred in 57 (95%) patients, including pneumothorax in 9 (15%), bleeding in 47 (78.3%), and hypoxemia in 1 (1.7%). The ultrasound images of DPLDs were normal, mesh (n=24), nodular (n=9), and alveolar type (n=27).

Conclusions: Transbronchial cryobiopsy guided by RP-EBUS is safe and effective and can supply additional information to the clinicoradiological approach for correct diagnosis of DPLDs.
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http://dx.doi.org/10.21037/qims-21-255DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739114PMC
February 2022

Author Correction: Protective effects and mechanisms of high-dose vitamin C on sepsis-associated cognitive impairment in rats.

Sci Rep 2022 Jan 28;12(1):1874. Epub 2022 Jan 28.

Department of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, 12 Jiankang Road, Shijiazhuang, 050011, Hebei, China.

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http://dx.doi.org/10.1038/s41598-022-05819-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799725PMC
January 2022

Radiomics and Radiogenomics in Evaluation of Colorectal Cancer Liver Metastasis.

Front Oncol 2021 7;11:689509. Epub 2022 Jan 7.

CT-MRI Room, Affiliated Hospital of Hebei University, Baoding, China.

Colorectal cancer is one common digestive malignancy, and the most common approach of blood metastasis of colorectal cancer is through the portal vein system to the liver. Early detection and treatment of liver metastasis is the key to improving the prognosis of the patients. Radiomics and radiogenomics use non-invasive methods to evaluate the biological properties of tumors by deeply mining the texture features of images and quantifying the heterogeneity of metastatic tumors. Radiomics and radiogenomics have been applied widely in the detection, treatment, and prognostic evaluation of colorectal cancer liver metastases. Based on the imaging features of the liver, this paper reviews the current application of radiomics and radiogenomics in the diagnosis, treatment, monitor of disease progression, and prognosis of patients with colorectal cancer liver metastases.
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http://dx.doi.org/10.3389/fonc.2021.689509DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8776634PMC
January 2022

Radiation Dose Reduction in Head and Neck Computed Tomography Angiography.

Curr Med Imaging 2022 ;18(7):757-763

Department of Medical Imaging Affiliated Hospital of Hebei University, 212 Eastern Yuhua Road, Baoding City, Hebei Province, 071030 China.

Background And Aim: The study aims to investigate the feasibility of further radiation dose reduction via the application of a high iodine delivery rate combined with automatic current modulation technology (high noise index) in head and neck computed tomography angiography.

Methods: Sixty-four patients who underwent routine head and neck computed tomographic angiography were randomly divided into two groups: a low-dose group of 32 cases and an ultra-low-dose group of 32 cases. The same image reconstruction technique was applied in both groups using the 50% adaptive statistical iterative reconstruction method. Quantitative and qualitative image quality assessment of the carotid artery, computed tomographic dose index volume, dose length product, and effective dose of the two groups were analyzed.

Results: The two groups were not significantly (P>0.05) different in age, gender, and body mass index. Significant (P<0.001) reduction of radiation dose was observed in all the parameters of computed tomographic dose index volume (18.12%), dose length product (19.91%), and effective dose (19.84%) in the ultra-low-dose group. Quantitative and qualitative image assessment produced similar results between the two groups, except for the higher mean vascular computed tomographic values found in the ultra-low dose group.

Conclusion: Application of a higher iodine delivery rate combined with automatic current modulation technology (high noise index) in an existing low tube voltage protocol can further decrease the radiation dose and the total volume of contrast agent while maintaining similar image quality for patients undergoing computed tomography angiography of the head and neck, which can be recommended as the conventional scanning method.
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http://dx.doi.org/10.2174/1573405618666220118160535DOI Listing
July 2022

Editorial Expression of Concern: Asymmetrical middle cerebral artery bifurcations are more vulnerable to aneurysm formation.

Sci Rep 2022 01 14;12(1):1036. Epub 2022 Jan 14.

Department of Medical Research, Shijiazhuang First Hospital, Hebei Medical University, 36 Fanxi Road, Shijiazhuang, Hebei Province, 050011, China.

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http://dx.doi.org/10.1038/s41598-022-05081-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8760250PMC
January 2022

Greater hemodynamic stresses initiated the anterior communicating artery aneurysm on the vascular bifurcation apex.

J Clin Neurosci 2022 Feb 28;96:25-32. Epub 2021 Dec 28.

Department of Neurosurgery, The First Hospital, Hebei Medical University, Shijiazhuang, Hebei, China.

Objective: To investigate hemodynamic stresses associated with the anterior communicating artery (Acom) aneurysm formation using computational fluid dynamics (CFD) analysis.

Methods: Three-dimensional geometries of the anterior cerebral artery (ACA) bifurcations in 20 patients with Acom aneurysms and 20 control subjects were used for CFD analysis to investigate hemodynamic stresses including the total and dynamic pressure, wall shear stress (WSS), vorticity and strain rate.

Results: At the direct flow impinging center on the bifurcation apex, the total pressure was the maximal but decreased quickly from the impinging center to both daughter branches. The WSS, dynamic pressure, vorticity and strain rate were the minimal at the direct impinging center but increased rapidly and reached the peaks at both daughter branches. The ACA bifurcation angle was significantly (P < 0.001) greater in patients with than without Acom aneurysms (144.2° ± 4.1° vs. 105.1° ± 3.2°). Most aneurysms (70% and 85%, respectively) were deviated to the smaller daughter branch or to the daughter branch forming a smaller angle with the A1 segment of ACA, where the hemodynamic stresses were significantly (P < 0.05) greater than those on the contralateral daughter branch. After aneurysm formation, the hemodynamic stresses on the aneurysm dome were all significantly decreased compared with at the aneurysm initiation site with aneurysm virtual removal (P < 0.001).

Conclusion: Formation of the Acom aneurysm is closely associated with and is to decrease the locally abnormally enhanced hemodynamic stresses.
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http://dx.doi.org/10.1016/j.jocn.2021.12.005DOI Listing
February 2022

Postpartum cerebral arterial dissections: Clinical features and treatment.

Medicine (Baltimore) 2021 Nov;100(47):e27798

Henan Provincial People's Hospital, Zhengzhou University, China.

Abstract: Postpartum cerebral arterial dissections are rare, and the clinical features, diagnosis, and treatment approaches are not clear to many physicians. This study was to investigate the clinical features, diagnosis, and treatment of postpartum cerebral arterial dissections.One patient with postpartum cerebral arterial dissections enrolled in our hospital was analyzed. All patients with postpartum cerebral arterial dissections retrieved from the PubMed were also included in this study and analyzed.A total of 45 patients with postpartum cerebral arterial dissections were retrieved including our case, with an age range of 24 to 44 years (mean 34). Thirty-six (80%) patients were older than 30 years of age (mean 35). There were 17 cases of cesarean section, 14 cases of natural labor, and 14 cases whose delivery modes were not reported. The clinical symptoms included headache in 35 cases (78%) and neck pain in 14 (31%). The symptoms occurred at a mean time of 11 days (range 0-53 days) following delivery. Among 45 patients, arterial dissections involved unilateral carotid or vertebral artery in 29 cases (64%), bilateral carotid or vertebral arteries in 8 (18%), 3 arteries in 3 (7%), and all bilateral carotid and vertebral arteries in 5 (11%). Fourteen (31%) patients were treated with antiplatelet agents, 27 (60%) with anticoagulation, 7 (16%) with both antiplatelet and anticoagulation medications, and only 2 (4%) with stent angioplasty. The prognosis was complete recovery in 30 (86%) patients and mild focal neurological symptoms in 5 (14%).Postpartum cerebral arterial dissections are rare, and correct diagnosis relies on imaging examination. Prognosis is usually favorable in patients with early diagnosis and prompt treatment.
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http://dx.doi.org/10.1097/MD.0000000000027798DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8615341PMC
November 2021

Intramedullary Well-Differentiated Osteosarcoma: Imaging and Pathologic Findings in 17 Patients.

Curr Med Imaging 2021 Dec 22. Epub 2021 Dec 22.

Department of Radiology, The Third Hospital of Hebei Medical University 139 Ziqiang Road, Shijiazhuang, Hebei Province. China.

Background: Intramedullary well-differentiated osteosarcoma (IMWDOS) is rare and may easily be misdiagnosed.

Objective: This study was to investigate the clinical, imaging and pathological features of IMWDOS for correct diagnosis.

Materials And Methods: Seventeen patients with IMWDOS were enrolled and the clinical, imaging and pathological data were analyzed.

Results: There were 13 males and 4 females with an age range of 19-55 years (mean 32). The lesion was located at long bones in 16 patients and at the second region of acetabulum in one patient. Except for three patients with limited areas of lesions, all the other patients had wide areas of disease, and the lesion in long bones all involved the metaphysis area with possible extension towards the diaphysis. In imaging, the lesion usually had an unclear boundary with destruction of bone cortex, uneven thickness of the bone cortex, thick and coarse trabecula in the lesion, but few periosteal reaction and soft tissue masses. The lesion was histologically composed of spindle cells with slight atypia. Follow-up was performed 2-101 months (mean 37.7) in 14 cases, 10 years in one case and 26 years in the remaining two. At follow-up, 12 patients (12/17 or 70.6%) who had complete resection including amputation (n=2), wide excision (n=8) and endoprosthetic replacement (n=2) had no recurrence or metastasis. Among five patients with curettage, three (3/17 or 17.6%) were recurrent with two deaths, and the third one died during post-operation chemotherapy.

Conclusion: Intramedullary well-differentiated osteosarcoma tends to occur at the metaphysis of long bones, especially at the distal femur. Histological, clinical and imaging findings lack characteristics and should be closely combined to reach a correct diagnosis. The prognosis of patients with complete lesion resection is good while incomplete lesion curettage or resection will lead to recurrence and transformation into a highly malignant tumor.
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http://dx.doi.org/10.2174/1573405618666211222160039DOI Listing
December 2021

Whole-Brain Volume CT Angiography can Effectively Detect Early Ischemic Cerebrovascular Diseases.

Curr Med Imaging 2022 ;18(7):731-738

Department of Radiology, Handan City Central Hospital, Handan, 056001 Hebei Province, China.

Objective: To investigate the role of whole-brain volume computed tomography (CT) perfusion in assessing early ischemic cerebrovascular diseases.

Materials And Methods: Seventy-two patients with early ischemic cerebrovascular diseases who had undergone routine CT scan and 320-row volume CT whole-brain perfusion imaging within 8 h after admission were retrospectively enrolled in this one-center case-sectional study. The perfusion parameters of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and dynamic CT angiogram (4D-CTA) were obtained and analyzed.

Results: Among 72 patients, 29 cases with 37 cerebral ischemic lesions were found in plain CT scan, whereas 51 cases with 76 lesions were found in whole-brain CT perfusion, with 30.6% more patients being detected. The CBF value was significantly lower in the abnormal than normal corresponding perfusion area in the healthy hemisphere (P<0.05), while the MTT and TTP values were significantly higher in the abnormal than the normal corresponding area (P<0.05). 4D-CTA image suggested that 59 cases had different degrees of stenosis or occlusion, including 11 mild, 18 moderate, 21 severe, and 9 occlusive cases. Four-D-CTA imaging could detect significantly (P<0.05) more patients with abnormal perfusion in severe cerebral vascular stenosis or occlusion than those with no, mild or moderate stenosis (93.33% vs. 16.67%) (P<0.05). The stenosis of intracranial and carotid arteries was positively correlated with MTT and TTP values (P<0.05).

Conclusion: Whole-brain volume CT angiography can comprehensively display early cerebral ischemic lesions, cerebral blood perfusion status, and cerebral vascular stenosis, providing valuable information for early detection of ischemic cerebral diseases and appropriate treatment planning.
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http://dx.doi.org/10.2174/1573405617666211206091831DOI Listing
July 2022

Pipeline flex embolization device for the treatment of large unruptured posterior circulation aneurysms: Single-center experience.

J Clin Neurosci 2022 Feb 24;96:127-132. Epub 2021 Nov 24.

Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, Henan Province 450000, China. Electronic address:

Purpose: To investigate the safety and effect of the Pipeline Embolization Device (PED) Flex device in the treatment of large unruptured posterior circulation aneurysms in a single center.

Materials And Methods: Patients with large unruptured posterior circulation aneurysms which were treated with the PED Flex device were enrolled. The clinical, endovascular and follow-up data were analyzed, and the O'Kelly-Marotta (OKM) grading system was used to assess the aneurysm occlusion status.

Results: Fourteen patients with 14 large posterior circulation aneurysms who were treated with the PED Flex device were enrolled. The maximal diameter of aneurysm was 17.0 ± 3.9 mm. Fourteen PED Flex devices were deployed in 14 patients, with a technical success rate of 100%. All stents covered the aneurysm neck with good wall adherence and patent parent artery. Ten (71.4%) aneurysms were treated with a single PED Flex device each, and four (28.6%) patients experienced additional coiling. No neurological complications occurred in the periprocedural period. The mRS was 0 in eleven (78.6%) patients, 1 in two (14.3%), and 2 in one (7.1%) at discharge. All patients were followed up at 6-28 months (median 18), with an mRS score of 0 in all patients. Twelve (85.7%) patients experienced digital subtraction angiography 6-28 (median 18) months after the embolization procedure, and the OKM grade was D in nine (75%), C in two (16.7%), and B in one (8.3%).

Conclusion: The Pipeline Flex Embolization Device can be safely applied to treat large unruptured posterior circulation aneurysms with a high complete aneurysm occlusion rate at follow-up.
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http://dx.doi.org/10.1016/j.jocn.2021.11.006DOI Listing
February 2022

Dynamic Imaging Changes of COVID-19 Pneumonia at Different Stages.

Curr Med Imaging 2022 ;18(8):869-875

Affiliated Hospital of Hebei University, Baoding, Hebei Province, 071000, China.

Introduction: To investigate the Computed Tomography (CT) imaging characteristics and dynamic changes of COVID-19 pneumonia at different stages.

Methods: Forty-six patients infected with COVID-19 who had chest CT scans were enrolled, and CT scans were performed 4-6 times with an interval of 2-5 days.

Results: At the early stage (n=25), ground glass opacity was presented in 11 patients (11/25 or 44.0 %) and ground glass opacity mixed with consolidation in 13 (13/25 or 52.0 %) in the lung CT images. At the progressive stage (n=38), ground glass opacity was presented in only one patient (1/38 or 2.6 %) and ground glass opacity mixed with consolidation in 33 (33/38 or 86.8 %). In the early improvement stage (n=38), the imaging presentation was ground glass opacity alone in three patients (3/38 or 7.9 %) and ground glass opacity mixed with consolidation in 34 (34/38 or 89.5 %). In the late improvement (absorption) stage (n=33), the primary imaging presentation was ground glass presentation in eight patients (8/33 or 24.2 %) and ground glass opacity mixed with consolidation in 23 (23/33 or 69.7 %). The lesion reached the peak at 4-16 days after disease onset, and 26 (26/38 or 68.4 %) patients reached the disease peak within ten days. Starting from 6 to 20 days after onset, the disease began to be improved, with 30 (30/38 or 78.9 %) patients being improved within 15 days.

Conclusion: COVID-19 pneumonia will progress to the peak stage at a mediate time of seven days and enter the improvement stage at twelve days. Computed tomography imaging of the pulmonary lesion has a common pattern from disease onset to improvement and recovery and provides important information for evaluation of the disease course and treatment effect.
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http://dx.doi.org/10.2174/1573405617666211124092225DOI Listing
July 2022

Value of the 45-degree reverse oblique view of the carpal palm in diagnosing scaphoid waist fractures.

Injury 2022 Mar 11;53(3):1049-1056. Epub 2021 Nov 11.

Department of Radiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China 050051.

Objectives: To investigate the value of 45° reverse oblique view of the carpal palm in diagnosing scaphoid waist fracture and displacement.

Methods: Eighty-four patients with wrist injury and plain radiography including posteroanterior, lateral, Stecher, and 45° reverse oblique view of the wrist were analyzed for the detection rate in diagnosing scaphoid fractures and displacement. The degree of difficulty in the four views for detecting the scaphoid waist fracture and displacement was rated on a five-grade Likert scale.

Results: Among 84 patients, scaphoid waist fractures occurred in 43, and fracture displacement in 32. A significantly (P<0.01) greater rate of detecting the scaphoid waist fracture was found in the Stecher, and 45° reverse oblique view than in the posteroanterior and lateral views. The rate of detecting fracture displacement was significantly (P<0.01) greater in the Stecher and 45° reverse oblique view than in the posteroanterior and lateral views. The Stecher view had a significantly (P = 0.006) lower rate of detecting fracture displacement than the 45° reverse oblique view. It was significantly (P<0.001) easier to identify the scaphoid waist fracture and displacement with the 45° reverse oblique view and the Stecher view than with the posteroanterior and lateral view. The 45° reverse oblique view had the easiest degree to identify the scaphoid waist fracture displacement, followed by the Stecher view, the posteroanterior and the lateral view (P<0.001).

Conclusions: The 45° reverse oblique view clearly shows the scaphoid oblique view in the long axis for better observation of the scaphoid waist fracture and displacement.
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http://dx.doi.org/10.1016/j.injury.2021.10.023DOI Listing
March 2022

Safety and Efficacy of Endovascular Embolization of Ruptured Intracranial Aneurysms within 72 hours of Subarachnoid Hemorrhage.

J Neurol Surg A Cent Eur Neurosurg 2022 May 17;83(3):265-274. Epub 2021 Nov 17.

Department of Neurosurgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

Purpose:  The purpose of the study was to investigate the safety and efficacy of endovascular embolization of ruptured intracranial aneurysms within 72 hours of subarachnoid hemorrhage (SAH).

Materials And Methods:  Patients with intracranial aneurysms treated with embolization were divided into group A ( = 277), patients with ruptured aneurysms treated within 72 hours of SAH; group B ( = 138), patients with ruptured aneurysms treated beyond 72 hours; and group C ( = 93), patients with unruptured aneurysms.

Results:  Embolization was successful in all but four patients (99.2%). The periprocedural complication rate was 36.2% in group B, significantly ( < 0.05) greater than that in group A (24.5%) or group C (11.8%). The rebleeding rate was 9.7% (6/62 patients) in groups A and B after embolization and only 0.3% (1/346 patients) in aneurysms with total or subtotal occlusion. Of these three groups of patients, 69.7% in group A, 58.7% in group B, and 76.3% in group C achieved Glasgow Outcome Scale (GOS) score of 5 or modified Rankin Scale (mRS) score of 0- to 1 at discharge. A significant difference ( < 0.05) existed in the clinical outcome between the three groups. The percentages of patients without deficits (GOS 5 or mRS 0-1) and slight disability (mRS 2) were 80.2% in group A, 81.2% in group B, and 96.7% in group C. The mortality rate was 4.3% (12/277 patients) in group A and 7.2% (10/138 patients) in group B with no significant ( = 0.21) difference. Follow-up was performed at 3 to 54 months (mean 23.2), and the recanalization rate was 28.6% (32/112 patients) in group A, 22.4% (11/49 patients) in group B, and 28.6% (16/56 patients) in group C, with no significant differences ( = 0.15). Hydrocephalus occurred in 30.5% (39/128 patients) in group B, which was significantly ( < 0.01) greater than that in group A (9.4%) or group C (2.2%).

Conclusion:  Early embolization of ruptured cerebral aneurysms within 72 hours of rupture is safe and effective and can significantly decrease periprocedural complications compared with management beyond 72 hours. Timely management of cisternal and ventricular blood can reduce hydrocephalus incidence and improve prognosis.
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http://dx.doi.org/10.1055/s-0041-1731752DOI Listing
May 2022
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