21 results on '"Yu-kun Luo"'
Search Results
2. Patient satisfaction of radiofrequency ablation for symptomatic benign solid thyroid nodules: our experience for 2-year follow up
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Hongxia Zhang, Yukang Zhang, Yu-Kun Luo, Wen He, Bin Ning, Tengfei Yu, and Yang Guang
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Adult ,Male ,0301 basic medicine ,Thyroid nodules ,China ,Cancer Research ,medicine.medical_specialty ,Radiofrequency ablation ,medicine.medical_treatment ,lcsh:RC254-282 ,law.invention ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Patient satisfaction ,law ,Neoplasms ,Ultrasound ,Genetics ,medicine ,Humans ,Thyroid Nodule ,Aged ,Aged, 80 and over ,Radiofrequency Ablation ,business.industry ,Radiofrequency ablation (RFA) ,Nodule (medicine) ,Retrospective cohort study ,Middle Aged ,Ablation ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Treatment efficacy ,Treatment Outcome ,030104 developmental biology ,Oncology ,Patient Satisfaction ,030220 oncology & carcinogenesis ,Female ,Radiology ,medicine.symptom ,business ,Research Article ,Follow-Up Studies - Abstract
Background The patient satisfaction of symptoms improvement and disease factors that may affect long-term treatment efficacy of radiofrequency ablation (RFA) for non-functioning solid benign thyroid nodules (TNs) over a 2-year follow up study was investigated. Methods This retrospective study evaluated 194 non-functioning solid benign TNs of 103 patients. The TNs were categorized as small (≤5 ml), medium (5.1 to 13 ml), intermediate (13.1 to 30 ml) and large (over 30 ml) according to the initial volume of TNs before ablation. Clinical evaluation and contrast-enhanced ultrasound (CEUS) were carried out before ablation and the follow up at 1, 3, 6 months and every 6 months after ablation. All patients were asked to assess the cosmetic score (1–4 scores) and symptom score (0–10 scores) before ablation and every follow up after ablation. Results All patients underwent RFA without any major complications. The mean treatment sessions were 1.5 ± 0.6. 98 nodules required a single session (98/194, 50.5%), 87 required two sessions (87/194, 44.9%), 9 required three sessions (9/194, 4.6%). The average follow up months were 16.3 ± 5.6 (range, 6–24 months) and no nodule regrew in our study. After RFA treatment, the TNs volume significantly decreased (P
- Published
- 2019
3. Effect of Pressure on Liver Stiffness During the Development of Liver Fibrosis in Rabbits
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Qing Song, Rong Wu, Yu Kun Luo, Zi Yu Jiao, Wen Bo Tang, and Qinghua Xu
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Liver Cirrhosis ,Male ,musculoskeletal diseases ,0301 basic medicine ,medicine.medical_specialty ,animal structures ,Acoustics and Ultrasonics ,Portal venous pressure ,medicine.medical_treatment ,Biophysics ,Gastroenterology ,Extracellular matrix ,03 medical and health sciences ,Hepatic Artery ,0302 clinical medicine ,Liver stiffness ,Internal medicine ,Laparotomy ,medicine ,Animals ,Arterial Pressure ,Radiology, Nuclear Medicine and imaging ,Ultrasonography ,Radiological and Ultrasound Technology ,Portal Vein ,business.industry ,Ultrasound ,equipment and supplies ,Portal Pressure ,Surgery ,Disease Models, Animal ,030104 developmental biology ,medicine.anatomical_structure ,Blood pressure ,Liver ,Female ,030211 gastroenterology & hepatology ,Rabbits ,business ,Ligation ,Artery - Abstract
This study was designed to investigate whether hepatic arterial pressure and portal pressure have an effect on liver stiffness during the development of liver fibrosis. Liver fibrosis was induced in 50 healthy New Zealand white rabbits. Laparotomy was performed to measure liver stiffness, and the portal vein and hepatic artery were successively ligated to repeat the measurements. A significant difference was observed among liver stiffness values measured at different time points (F = 22.82, p < 0.001). Differences between original liver stiffness and liver stiffness measured after portal ligation were positively correlated with portal pressure (r = 0.801, p < 0.001). In animals with grade 4 liver fibrosis, the increase in liver stiffness caused by pressure was greater than that caused by extracellular matrix accumulation (p = 0.002). In conclusion, hepatic arterial pressure and portal pressure have a significant effect on liver stiffness during the development of liver fibrosis.
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- 2016
4. Evaluation of Elastic Stiffness in Healing Achilles Tendon After Surgical Repair of a Tendon Rupture Using In Vivo Ultrasound Shear Wave Elastography
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Yuexiang Wang, Lihai Zhang, Yu-kun Luo, Wenbo Wan, Peifu Tang, Zi-yu Jiao, and Lining Zhang
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Adult ,Male ,medicine.medical_specialty ,Achilles Tendon ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Elasticity Imaging Techniques ,0302 clinical medicine ,Tendon Injuries ,Clinical Research ,Elastic Modulus ,medicine ,Humans ,Orthopedic Procedures ,Ultrasonics ,Foot Injuries ,Aged ,Ultrasonography ,Surgical repair ,Rupture ,Achilles tendon ,Wound Healing ,business.industry ,Ultrasound ,030229 sport sciences ,General Medicine ,Middle Aged ,Plastic Surgery Procedures ,musculoskeletal system ,Surgery ,Tendon ,medicine.anatomical_structure ,Treatment Outcome ,Orthopedic surgery ,Female ,Ankle ,Achilles tendon rupture ,medicine.symptom ,business - Abstract
BACKGROUND There has been no published report assessing the mechanical properties of a repaired Achilles tendon after surgery using shear wave elastography (SWE). The aim of this study was to investigate the changes in mechanical properties of the healing Achilles tendon after surgical repair of a tendon rupture using ultrasound SWE and how these changes correlate with tendon function. MATERIAL AND METHODS Twenty-six patients who underwent surgical repair for Achilles tendon rupture were examined with ultrasound SWE coupled with a linear array transducer (4-15 MHz). The elasticity values of the repaired Achilles tendon in a longitudinal view were measured at 12, 24, and 48 weeks postoperatively. Functional outcomes were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system at 12, 24, and 48 weeks postoperatively. General linear regression analysis and correlation coefficients were used to analyze the relationship between elasticity and the AOFAS score. RESULTS There were significant differences with respect to the mean elasticity values and functional scores of the repaired Achilles tendon at 12, 24, and 48 weeks postoperatively (all P
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- 2016
5. Contrast-enhanced Gray-scale Transrectal Ultrasound-guided Prostate Biopsy in Men with Elevated Serum Prostate-specific Antigen Levels
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Huaiyin Shi, Yu-Kun Luo, Jie Tang, Jing Chun Yang, Junlai Li, and Yanmi Li
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Male ,medicine.medical_specialty ,Prostate biopsy ,Urology ,Sensitivity and Specificity ,Prostate cancer ,Prostate ,Biopsy ,Biomarkers, Tumor ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Ultrasonography, Interventional ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Biopsy, Needle ,Prostatic Neoplasms ,Reproducibility of Results ,Cancer ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Ultrasound-Guided Prostate Biopsy ,Prostate-specific antigen ,medicine.anatomical_structure ,Transrectal biopsy ,business - Abstract
Rationale and Objectives Our goal was to evaluate the role of contrast-enhanced gray-scale transrectal ultrasound (CETRUS)-guided prostate biopsy in patients with elevated serum prostate-specific antigen (PSA) levels. Materials and Methods A total of 115 men (mean age, 70 years; range, 47−85) with serum PSA levels of greater than 4.0 ng/ml were assessed using gray-scale transrectal ultrasound (TRUS), power Doppler ultrasound (PDU), and CETRUS. Subsequently, these patients underwent systematic sextant transrectal biopsy and additional biopsies for positive sites on gray-scale TRUS, PDU, and CETRUS. The cancer detection rates of the three techniques were compared. Results Cancer was detected in 63 of the 115 patients (55%). CETRUS was positive in 50 patients, 35 of whom (70%) had prostate cancer; CETRUS had a higher sensitivity, specificity, and accuracy of 65% (41/63), 83% (43/52), and 73% (84/115), respectively. CETRUS could have saved a significant number of patients from undergoing unnecessary biopsies, compared to TRUS and PDU. However, no significant correlation was found between the Gleason score and CETRUS grade. Conclusions The use of CETRUS in detecting prostate cancer might reduce the number of unnecessary needle biopsies of the prostate in patients with abnormally high serum PSA levels and increase the detection rate of clinically significant prostate cancer.
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- 2008
6. Elevated Human Endothelial Cell-Specific Molecule-1 Level and Its Association With Coronary Artery Disease in Patients With Hypertension
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Fu-dong Hu, Lianglong Chen, Lingzhen Wu, Chaogui Lin, Zhao-yang Chen, Chang Xiong, Zi-Wen Zhao, and Yu-kun Luo
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Coronary angiography ,Male ,medicine.medical_specialty ,Coronary Artery Disease ,Severity of Illness Index ,General Biochemistry, Genetics and Molecular Biology ,Coronary artery disease ,Internal medicine ,Severity of illness ,Medicine ,Humans ,In patient ,Endothelial dysfunction ,Endothelial Cell-Specific Molecule 1 ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Pathophysiology ,Neoplasm Proteins ,Increased risk ,Hypertension ,Cardiology ,Female ,Proteoglycans ,business - Abstract
Background Endothelial dysfunction plays an important role in the pathophysiology of coronary artery disease (CAD). Previous studies suggested that human endothelial cell-specific molecule-1 (endocan) may be a novel endothelial dysfunction marker. This study aims to investigate the relationship between serum endocan level and the presence and severity of CAD in patients with hypertension. Methods A total of 190 eligible hypertension patients were enrolled in this study. Serum endocan level was measured by enzyme-linked immunosorbent assay. The presence and severity of CAD were evaluated by coronary angiography. Results Hypertensive patients with CAD had significantly higher serum endocan level than those without CAD (1.63 ± 0.51 ng/mL vs 1.31 ± 0.65 ng/mL, P < 0.05). Multivariate logistic regression revealed that serum endocan level was independently associated with the presence of CAD (odds ratio, 2.662; 95% confidence interval, 1.560–4.544; P < 0.001). Spearman rank correlation analysis demonstrated that serum endocan level was associated with SYNergy between PCI with TAXUS and Cardiac Surgery score (r = 0.349, P = 0.001). Conclusions Serum endocan level is independently correlated with the presence and severity of CAD in hypertension patients, and those with high endocan level may have an increased risk of developing atherosclerosis.
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- 2015
7. Contrast-enhanced ultrasound may distinguish gallbladder adenoma from cholesterol polyps: a prospective case-control study
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Jian-Hon Xu, Hong-tian Li, Wen-Ping Lu, Yu-Kun Luo, Xiang Fei, Yan-Mi Li, Huai-yin Shi, and Zi-Yu Jiao
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Adenoma ,Adult ,Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Contrast Media ,Gallbladder Diseases ,Gastroenterology ,Diagnosis, Differential ,Vascularity ,Polyps ,Risk Factors ,Internal medicine ,Gallbladder polyp ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Aged ,Ultrasonography ,Radiological and Ultrasound Technology ,business.industry ,Gallbladder ,Echogenicity ,General Medicine ,Middle Aged ,medicine.disease ,Image Enhancement ,digestive system diseases ,medicine.anatomical_structure ,Cholesterol ,Case-Control Studies ,Cholecystectomy ,Female ,Gallbladder Neoplasms ,Radiology ,medicine.symptom ,business ,Contrast-enhanced ultrasound ,Gallbladder Adenoma - Abstract
The aim of this study was to find the independent risk factors related with gallbladder (GB) adenoma compared to cholesterol polyp by contrast-enhanced ultrasound (CEUS). Between January 2010 and September 2014, a total of 122 consecutive patients undergoing cholecystectomy for GB polypoid lesions were enrolled. Before cholecystectomy, each patient underwent conventional US and CEUS examination and all image features were documented. The patients were divided into adenoma group and cholesterol polyp group according to the pathological findings. All the image features between two groups were statistically compared. There were differences in patient age, lesion size, echogenicity, and vascularity of lesion between two groups (P
- Published
- 2015
8. Ultrasound-guided radiofrequency ablation of the segmental Glissonian pedicle: A new technique for anatomic liver resection
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Yu-kun Luo, Wenbin Ji, Min Yao, Kai Jiang, Jia-hong Dong, Jiye Chen, and Shou-wang Cai
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Adult ,Liver Cirrhosis ,Male ,medicine.medical_specialty ,China ,Carcinoma, Hepatocellular ,Radiofrequency ablation ,Swine ,medicine.medical_treatment ,Catheter ablation ,Pilot Projects ,030230 surgery ,Risk Assessment ,Resection ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Medicine ,Animals ,Hepatectomy ,Humans ,Survival rate ,Ultrasonography, Interventional ,Aged ,business.industry ,Liver Neoplasms ,Middle Aged ,Ablation ,medicine.disease ,Surgery ,Survival Rate ,Disease Models, Animal ,Treatment Outcome ,Liver ,Biliary tract ,Hepatocellular carcinoma ,Catheter Ablation ,Swine, Miniature ,030211 gastroenterology & hepatology ,Female ,business ,Follow-Up Studies ,Forecasting - Abstract
Background Anatomic liver resection is widely accepted as the optimal surgical treatment for hepatocellular carcinoma (HCC); however, the complexity of conventional operative methods limits their use. To explore the possibility of using modern techniques to achieve a simpler approach, we have evaluated ultrasound-guided segmental radiofrequency ablation (RFA) of the Glissonian pedicle before liver resection in a porcine model and in HCC patients. Methods This study had 2 stages. First, we piloted anatomic liver resection using ultrasound-guided RFA of the segmental Glissonian pedicle in 6 Bama miniature pigs. Having found this technique safe and effective, we selected 21 HCC patients to treat with the same approach. Results The pigs had no postoperative mortality or morbidity. Demarcation areas were apparent in all targeted segments. The mean length of segmental portal, arterial, and biliary tract branches ablated was 1.7, 1.4, and 1.6 cm, respectively. Human HCC operations consisted of 8 subsegmentectomies, 8 segmentectomies, and 5 multisegmentectomies. The procedure was feasible in all patients, with no mortality, morbidity, or need for blood transfusions. A demarcation area was apparent in all patients within 157 seconds of RF application for each target feeding vessel. The mean number of target feeding vessels was 2 (range, 1–7). Conclusion Our study demonstrates that ultrasound-guided RFA ablation of the segmental Glissonian pedicle is expedient, safe, and effective, and is suitable for resection of any hepatic segments or subsegments, from segments 2 to 8.
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- 2015
9. Correlation between prostate cancer grade and vascularity on color doppler imaging: Preliminary findings
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Huaiyin Shi, Song Li, Gaokui Zhang, Yan Zhang, Jie Tang, Xin Li, Junlai Li, Yu-Kun Luo, and Jian-Hong Xu
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Male ,medicine.medical_specialty ,Prostate biopsy ,Biopsy ,symbols.namesake ,Prostate cancer ,Vascularity ,Prostate ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Neoplasm Staging ,Neovascularization, Pathologic ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Prostatic Neoplasms ,medicine.disease ,Echocardiography, Doppler, Color ,medicine.anatomical_structure ,Regional Blood Flow ,symbols ,Transrectal ultrasonography ,Radiology ,medicine.symptom ,business ,Doppler effect - Abstract
Purpose We examined the relationship between the amount of prostate cancer–associated vascularity as seen on color Doppler imaging and the tumor grade. Methods Transrectal color Doppler imaging of the prostate was performed in 54 patients with prostate cancer. Color flow signal/total pixel ratios (SPRs) of selected images were calculated using the ratio of the number of pixels showing color Doppler signals to the total number of pixels within the lesion. All the patients underwent prostate biopsy guided by transrectal sonography. Gleason scores were determined from the biopsy specimens. Results Color Doppler signals were demonstrated in the lesions of 91% (49/54) of the patients. The mean SPRs of prostate cancers 3 cm or smaller and larger than 3 cm were 0.15 ± 0.07 and 0.11 ± 0.04 (± standard deviation), respectively (p < 0.05). The mean SPRs of well- (Gleason score of 2–4), moderately (Gleason 5–7), and poorly (Gleason 8–10) differentiated prostate cancers were 0.08 ± 0.03, 0.12 ± 0.06, and 0.17 ± 0.11, respectively (r = 0.45; p < 0.01). Conclusions The refinement of color Doppler equipment has improved the detection of color Doppler signals associated with prostate cancer. Our study shows a correlation between prostate cancer–associated vascularity as shown on color Doppler imaging and the tumor grade. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:61–68, 2003
- Published
- 2003
10. Comparison of effectiveness and cost between perventricular device occlusion and minimally invasive surgical repair for perimembranous ventricular septal defect
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Chuan Chuan Li, Wan Hua Chen, Yu Kun Luo, Chang Xiong, and Liang Long Chen
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Heart Septal Defects, Ventricular ,Male ,medicine.medical_specialty ,Percutaneous ,medicine.medical_treatment ,Cicatrix ,Occlusion ,Medicine ,Humans ,Minimally Invasive Surgical Procedures ,Child ,Retrospective Studies ,Surgical repair ,business.industry ,Vascular surgery ,medicine.disease ,Sternotomy ,Cardiac surgery ,Surgery ,Treatment Outcome ,Thoracotomy ,Median sternotomy ,Anesthesia ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,Cardiology and Cardiovascular Medicine ,business ,Complication ,Atrioventricular block - Abstract
Perventricular device occlusion and minimally invasive surgical repair for perimembranous ventricular septal defect (pmVSD) are two typical methods to reduce the invasiveness of the conventional operation through median sternotomy. However, few comparative studies have been made between them in terms of effectiveness and cost. A review was made of the inpatients with isolated pmVSD, who had undergone perventricular device occlusion or minimally invasive surgical repair from June 2011 and January 2013 for a comparative investigation between the two procedures. The two treatment groups had similar baseline characteristics. Procedural success was achieved in 163 (94.8 %) of the perventricular and 137 (98.6 %) of the surgical (P = 0.136). Major complications occurred in 2 (1.2 %) of the perventricular and 4 (2.9 %) of the surgical (P = 0.497), and minor complications, in 57 (33 %) of the percutaneous and 49 (35.2 %) of the surgical (P = 0.696). In cost, the surgical repair was 30.5 % cheaper than the device occlusion (Yuan 20139 ± 3760 vs. 28970 ± 3343, P
- Published
- 2014
11. Low serum adropin is associated with coronary atherosclerosis in type 2 diabetic and non-diabetic patients
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Jun Fang, Zi-Wen Zhao, Lianglong Chen, Lingzhen Wu, Yu-kun Luo, Chaogui Lin, and Lin Fan
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Male ,medicine.medical_specialty ,Clinical Biochemistry ,Enzyme-Linked Immunosorbent Assay ,Coronary Artery Disease ,Type 2 diabetes ,Coronary artery disease ,Internal medicine ,Diabetes mellitus ,Odds Ratio ,medicine ,Humans ,Coronary atherosclerosis ,Aged ,business.industry ,Biochemistry (medical) ,Blood Proteins ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Radiography ,Logistic Models ,Diabetes Mellitus, Type 2 ,Quartile ,Cardiology ,Intercellular Signaling Peptides and Proteins ,Female ,Peptides ,business ,Non diabetic - Abstract
Diabetes increases the risk and severity of atherosclerosis. Adropin, a metabolic homeostasis-related protein, has been implicated in the maintenance of metabolic homeostasis. We examined the relationship between serum adropin level and angiographic severity of coronary atherosclerosis in diabetic and non-diabetic patients.A total of 392 patients with suspected coronary artery disease, who underwent coronary angiography, were assigned into the type 2 diabetic and non-diabetic groups and also classified into four groups according to the quartiles of adropin level. Venous serum samples were collected for adropin measurement by enzyme-linked immunosorbent assay and for biochemistry assay. The angiographic severity of coronary atherosclerosis was assessed by Gensini, Friesinger, and SYNTAX scores.Compared with non-diabetic patients, diabetic patients had lower serum adropin level and higher Gensini, Friesinger and SYNTAX scores (all p0.001). Serum adropin level was inversely correlated with the Gensini, Friesinger and SYNTAX scores (rs=-0.389, -0.390 and -0.386, respectively, all p0.001) among all patients. Low adropin level was an independent predictor of clinically relevant coronary atherosclerosis (SYNTAX score11), both in diabetic patients [odds ratio (OR) 0.66, 95% confidence interval (CI) 0.53-0.83; p0.001] and in non-diabetic patients (OR 0.51, 95% CI 0.35-0.74; p0.001).Serum adropin level was significantly lower in type 2 diabetic patients than in non-diabetic patients and was inversely and independently associated with angiographic severity of coronary atherosclerosis, suggesting that serum adropin serves as a novel predictor of coronary atherosclerosis.
- Published
- 2014
12. [Ablation of segmental glissonian pedicle by ultrasound-guided radiofrequency in precision liver resection in a porcine model]
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Ji-ye, Chen, Yu-kun, Luo, Kai, Jiang, and Jia-hong, Dong
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Male ,Swine ,Catheter Ablation ,Animals ,Hepatectomy ,Swine, Miniature ,Female ,Ultrasonography - Abstract
To demonstrate the ablation of segmental glissonian pedicle by ultrasound-guided radiofrequency in precision liver resection in porcine model.The study was carried out on 6 Bama miniature pigs. Coagulative desiccation of the vessels feeding the segment to be resected was induced by introduction of a "cooled-tip" radiofrequency electrode under intraoperative ultrasound guidance at the level of the vessels. Then, an area of marked discoloration on the surface of the liver became obvious. Liver parenchymal transection followed without any form of hepatic inflow occlusion. Three segments (segment 3, 5, and 6) were resected on each pig. The criteria studied the local and general tolerance, the change of blood flow parameters of each segmental arterial and portal branches, and the microscopic appearance of the segmental arterial, portal and biliary tract branches. Using t test as the statistical methods.Postoperative mortality and morbidity were 0 and all serum parameters had normalized by 14 days. Demarcation area was obtained in 15 segments. The flow rate of the resected segmental portal branches was 0 cm/s after radiofrequency and the value of the arterial branches was (28 ± 18) cm/s which was significantly lower than pre-radiofrequency, which were (10.2 ± 3.0) cm/s and (60 ± 17) cm/s (t = 14.439, 5.502; P = 0.000). There was no significant difference in the flow rate of the remnant segmental arterial and portal branches among pre-radiofrequency, post-radiofrequency and 14 days after operation. On microscopic observation, the mean ablated length of segmental portal, arterial and biliary tract branches were (1.6 ± 0.4) cm, (1.2 ± 0.4) cm, and (1.7 ± 0.3) cm respectively.The ablation of the segmental glissonian pedicle by ultrasound-guided radiofrequency is quick, safe and effective. The probe needs to be away from vessels feeding segments 1.5 cm at least to avoid thermal injuries.
- Published
- 2012
13. Modified culotte stenting for treatment of complex coronary bifurcation lesions: immediate and 9-month outcomes in a pilot study
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Liang-long, Chen, Lin, Fan, Zhao-yang, Chen, Xing-chun, Zhen, Yu-kun, Luo, Chao-gui, Lin, and Ya-fei, Peng
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Aged, 80 and over ,Male ,Humans ,Drug-Eluting Stents ,Female ,Coronary Artery Disease ,Prospective Studies ,Angioplasty, Balloon, Coronary ,Middle Aged ,Coronary Angiography ,Aged - Abstract
The optimal stenting strategy for the treatment of coronary bifurcation lesions (CBLs) remains uncertain. The present study observed technical feasibility and reliability, 9-month clinical and angiographic outcomes of the modified culotte stenting (MCS) in the treatment of CBLs with drug-eluting stents.A total of 34 consecutive patients with CBLs that required stenting the parent vessel (PV), the main branch (MB) and the side branch (SB) were included. All patients were first assigned to receive MCS for CBL interventions (per MCS), and might be switched to receive the double-kissing-crush stenting (DKS) in case of temporally acute branch occlusion (per protocol).The immediate angiographic or procedural success was achieved in 33/34 (97%) lesions (patients) per MCS, 34/34 (100%) lesions (patients) per protocol with 100% successful final balloon kissing. The long-term clinical success at 9 months was 94% per MCS and 94% per protocol, only 2 patients had reoccurrence of angina but none of them needed target lesion revascularization. There were no procedure-related biomarker elevation, no in-stent thrombosis peri-procedurally and at 9-month follow-up. Quantitative coronary angiography data at 9 months showed that in-stent (6%) or in-segment (6%) binary stenosis was infrequent, and minimal lumen diameter was significantly reduced but late lumen loss was acceptable with only (0.10 ± 0.14) mm for PV, (0.21 ± 0.23) mm for MB and (0.27 ± 0.32) mm for SB.MCS for treatment of CBLs that required dual-stent implantation was technically easier and safer, readily to complete final balloon kissing, and was associated with high immediate success and optimal 9-month outcomes.
- Published
- 2011
14. [Causes and management of ischemic-type biliary lesion after orthotopic liver transplantation]
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Xin, Jin, Xian-jie, Shi, Mao-qiang, Wang, Yu-kun, Luo, Feng-chun, Cai, Yu-rong, Liang, Ying, Luo, Wen-bin, Ji, Wei-dong, Duan, and Jia-hong, Dong
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Adult ,Male ,Adolescent ,Bile Duct Diseases ,Middle Aged ,Liver Transplantation ,Young Adult ,Postoperative Complications ,Ischemia ,Humans ,Female ,Child ,Aged ,Retrospective Studies - Abstract
To discuss the causes, diagnosis, prophylaxis and treatment of ischemic-type biliary lesions (ITBLs) following orthotopic liver transplantation (OLT).A retrospective analysis was performed for 326 OLT patients from January 2002 to January 2009. The post-OLT etiological factors and treatment of ITBL cases were analyzed.ITBL occurred in 23 patients (7.05%). It included intrahepatic biliary lesions (n=9), extrahepatic lesions (n=12) and diffuse extrahepatic and intrahepatic biliary lesions (n=2). Through a COX regression, the risk factors were independently associated with ITBL serious hepatitis as the primary disease (RR: 3.204; P=0.014) and cold donor ischemic time beyond 11.5 hours (RR: 4.895; P=0.000). All ITBL patients underwent drug therapy, endoscopy (n=10), operation (n=6) or re-OLT (n=7). And improvement was found in 17 patients.Avoiding too long old ischemic time of donor liver and carefully evaluating the indications of recipients are effective preventive measures of ITBL. It is crucial to select a proper treatment according to the conditions of each individual patient.
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- 2011
15. [Predictive value of sonographic features in preoperative evaluation of malignant thyroid nodules]
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Zhao-hui, Lü, Hai-qing, Zhu, Jing-tao, Dou, Yu-kun, Luo, Qing-long, Kong, Guo-qing, Yang, Jian-ming, Ba, Yi-ming, Mu, and Ju-ming, Lu
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Adult ,Diagnosis, Differential ,Male ,Predictive Value of Tests ,Humans ,Female ,Thyroid Neoplasms ,Thyroid Nodule ,Middle Aged ,Retrospective Studies ,Ultrasonography - Abstract
To retrospectively evaluate the diagnostic accuracy of ultrasonographic (US) features for the pre-operative differentiation of benign and malignant thyroid nodules by using pathological diagnosis as the reference standard.A total of 1501 patients with 2123 thyroid nodules (1864 malignant, 259 benign) diagnosed intra-operatively and undergoing pre-operative ultrasonography at our hospital were recruited. The following characteristics of US images were evaluated: nodule size, shape, margin, echotexture, echogenicity, presence and type of calcification, blood flow inside or around nodules and the presence of ipsilateral cervical lymphadenectasis.(1) The risk of malignancy was higher in a solitary nodule than in a non-solitary nodule [16.7% (109/653) vs 10.2% (150/1470), P=0.000]. The mean diameter of benign nodules was larger than that of malignant nodules [(2.4±1.4) vs (2.1±1.9) cm, P=0.009]. (2) Microcalcification, irregular shape, ill-defined border, solid and hypoechogenicity were more common in malignant nodules. Irregular shape had the highest sensitivity and positive predictive value while microcalcification had the highest diagnostic accuracy. (3) Nodules with a rich blood flow inside tended to have a higher risk of malignancy. The distribution pattern of blood flow around the nodules was not associated with the differentiation of benign and malignant thyroid nodules. Nodules with the presence of ipsilateral cervical lymphadenectasis had a higher risk of malignancy than those without lymphadenectasis [28.3% (80/283) vs 9.6% (92/963), P0.01]. (4) If microcalcification, irregular shape, ill-defined border, solid, hypoechogenicity and the presence of ipsilateral cervical lymphadenectasis were treated as the characteristics of malignancy, a higher frequency of these characteristics was correlated with a higher risk of malignancy.Despite a lack of specific US imaging characteristics in malignant thyroid nodules, microcalcification and irregular shape appear closely correlated with malignancy. A combined use of conventional US characteristics may improve the accuracy of differential diagnosis.
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- 2011
16. [Clinical value of contrast-enhanced ultrasound in the diagnosis of Budd-Chiari syndrome with inferior vena cava obstruction]
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Yu-Kun, Luo, Jun-Lai, Li, Yue-Xiang, Wang, Zhi-Li, Wang, Jian-Hong, Xu, Jie, Tang, and Mao-Qiang, Wang
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Adult ,Male ,Young Adult ,Adolescent ,Humans ,Female ,Vena Cava, Inferior ,Budd-Chiari Syndrome ,Middle Aged ,Ultrasonography - Abstract
To explore the clinical value of contrast-enhanced ultrasound (CEUS) in the diagnosis of Budd-Chiari syndrome with inferior vena cava (IVC) obstruction.A total of 38 patients with Budd-Chiari syndrome with IVC obstruction were examined by CEUS before and after vascular interventional management, and the results were compared with angiographic findings.The location and degree of IVC obstruction were clearly showed on CEUS. Enhancement was found in the occlusion site, and blood flow was narrowed at the stenosis site. The arrival time was earlier after treatment in the IVC obstruction, and it was positively correlated with the pressure of IVC( P0.05).The location and type of the occlusion and stenosis in IVC can be accurately determined by CEUS. Therefore, CEUS can provide useful information for the selection of surgical procedures and post-operative effectiveness.
- Published
- 2010
17. Comparison of long-term clinical outcome between transcatheter Amplatzer occlusion and surgical closure of isolated patent ductus arteriosus
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Zhao-yang, Chen, Li-ming, Wu, Yu-kun, Luo, Chao-gui, Lin, Ya-fei, Peng, Xing-chun, Zhen, and Liang-long, Chen
- Subjects
Adult ,Male ,Cardiac Catheterization ,Adolescent ,Infant ,Middle Aged ,Young Adult ,Treatment Outcome ,Echocardiography ,Child, Preschool ,Humans ,Female ,Child ,Ductus Arteriosus, Patent - Abstract
Transcatheter Amplatzer occlusion of patent ductus artertiosus (PDA) has emerged as a minimally invasive alternative to surgical closure. The goal of this study was to compare long-term clinical outcomes between two procedures, especially on chronic residual shunt, late or very late procedure-related complications, and regression of pulmonary hypertension and left ventricular dilation.A total 255 patients having isolated PDA with a minimal diameter ofor= 4 mm treated from January 2000 to July 2003 were included in this study and have been followed up until July 2008. The patients were assigned to either the device or surgical closure group according to the patients' and/or their parents' preference. Baseline physical exams, chest roentgenography, electrocardiography, and echocardiography were performed preprocedure and at each follow-up.Seventy-two patients accepted the transcatheter procedure (Group-TC) and 183 underwent surgical operation (Group-SO) for PDA closure, both groups were similar in their demographics and preoperative clinical characteristics. There were no cardiac deaths and late complications such as infectious endocarditis and Amplatzer duct occluder (ADO) dislodge in either group. More acute procedure-related complications were recorded in Group-SO (13.7%) compared with Group-TC (1.4%) (P = 0.004). The recovery time was (8.7 +/- 2.3) days for the Group-SO and (1.3 +/- 0.5) days for the Group-TC (P0.001). The survival freedom from persistent residual shunt, defined as residual shunt that can not resolve automatically, was 91.3% for Group-SO and 98.6% for Group-TC (P = 0.037 by Log-rank test). There was no significant difference in regression of pulmonary hypertension and left ventricular dilation; neither survival freedom from pulmonary hypertension nor abnormal left ventricular end-diastolic volume index were significantly different between the surgical group and the Amplatzer group.Our study confirmed the long-term safety and efficacy of transcatheter Amplatzer occlusion. In comparison to the time-proven surgical closure, transcatheter Amplatzer occlusion was less invasive and associated with fewer complications and residual shunt, and as effective in the regression of pulmonary hypertension and left ventricular dilation.
- Published
- 2009
18. Firebird and cypher sirolimus-eluting stents and bare metal stents in treatment of very long coronary lesions
- Author
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Lin, Fan, Liang-long, Chen, Chao-gui, Lin, Ya-fei, Peng, Xing-chun, Zheng, Yu-kun, Luo, Fei-long, Zhang, Jian-hua, Chen, Xiao-ping, Yan, and Zheng-rong, Huang
- Subjects
Adult ,Aged, 80 and over ,Male ,Sirolimus ,Adolescent ,Drug-Eluting Stents ,Coronary Artery Disease ,Middle Aged ,Coronary Angiography ,Coronary Restenosis ,Metals ,Humans ,Female ,Stents ,Prospective Studies ,Angioplasty, Balloon, Coronary ,Aged - Abstract
As a kind of sirolimus-eluting stent (SES) made in China, Firebird SES is more effective than bare metal stent (BMS) and not inferior to Cypher SES for short coronary lesions in terms of reduction of restenosis and revascularization. However, Firebird SES does not show any benefits in patients with a very long coronary lesion (VLCL). The present study was undertaken to evaluate the safety and efficacy of Firebird SES for VLCL by comparison of Cypher SES and BMS.In this prospective, nonrandomized and comparative study, eligible patients with de novo coronary lesion (or = 30 mm) between January 2005 and June 2006 were allocated into Firebird SES group, Cypher SES group or BMS group. They were subjected to an angiographic follow-up of 6 months and a clinical follow-up of 12 months. The primary endpoints constitute the in-stent and in-segment restenosis rates at 6 months. The secondary endpoint was defined as a major adverse cardiovascular event (MACE) that was a 12-month combined endpoint of all-cause deaths, reinfarction or in-stent thrombosis, and target-lesion revascularization. The 12-month in-stent thrombosis was also evaluated to address the safety of Firebird SES implantation exceptionally.A total of 468 patients were assessed for eligibility. Of 113 patients who were finally included according to the prior inclusion and exclusion criteria, 39 (41 lesions) were treated with Firebird SES, 37 (39 lesions) with Cypher SES, and 37 (37 lesions) with BMS. There were no significant differences in the baseline characteristics between the three groups; but there were longer lesions, more frequent use of overlapping stent in the Firebird SES group and the Cypher SES group. Angiographic follow-up showed that the rates of binary stenosis were similar between the Firebird SES group and the Cypher SES group (in-segment: 14.6% vs 12.8%, relative risk (RR) 1.14, P = 0.81; in-stent: 9.8% vs 10.3%, RR 0.95, P = 0.94), and significantly lower than those in the BMS group (in-segment: vs. 36.1%, RR 0.41 or 0.36, P = 0.04 or 0.03, respectively; in-stent: vs 30.6%, RR 0.32 or 0.34, P = 0.03 or 0.04, respectively). The total MACE rate up to 12 months was also similar in both SES groups (7.7% vs 5.4%, P = 1.000), and significantly lower than that in the BMS group (27.0%, P = 0.034 or 0.024, respectively). The in-stent thrombosis rate in the follow-up period was 2.6% in the Firebird SES group, not higher in the Cypher SES and BMS groups (2.7% and 2.7%, respectively, P = 1.000).In the treatment of VLCL, Firebird SES would be safer and more effective than BMS. Firebird SES may be not inferior to Cypher SES in terms of restenosis and MACE.
- Published
- 2008
19. Does benign prostatic hyperplasia originate from the peripheral zone of the prostate? A preliminary study
- Author
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Lei Zhang, Xin Liu, Zhiping Wang, Yu-Kun Luo, Junlai Li, Jian-Hong Xu, Jie Tang, Yan Zhang, Jing Chun Yang, and Huaiyin Shi
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Stromal cell ,Proliferation index ,Urology ,Prostatic Hyperplasia ,Transforming Growth Factor beta1 ,Prostate ,Biopsy ,medicine ,Humans ,Aged ,Cell Proliferation ,Ultrasonography ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Hyperplasia ,Middle Aged ,medicine.disease ,Immunohistochemistry ,Epithelium ,ErbB Receptors ,medicine.anatomical_structure ,Proto-Oncogene Proteins c-bcl-2 ,Receptors, Androgen ,business ,Immunostaining - Abstract
To compare the histological characteristics, cell proliferation, apoptosis and biological features in benign prostatic hyperplasia (BPH) in the peripheral (PZ) and transition zone (TZ) of the prostate.Tissue from BPH in TZ and PZ was obtained from 68 patients undergoing transrectal ultrasonography-guided biopsy and used for both morphometric analysis and immunohistochemical studies. The epithelial, stromal and luminal composition of the tissue was determined using a computer-assisted method for quantitative morphometric analysis. Apoptosis was detected as the apoptotic index (AI) using the TdT dUTP nick-end labelling assay. Cell proliferation was determined as the proliferation index (PI) using Ki-67 immunostaining. The expression of epidermal growth factor receptor (EGFR), transforming growth factor beta1 (TGFbeta1), androgen receptor (AR) and bcl-2 were assessed immunohistochemically.There was no difference in the stroma/epithelium ratio between PZ and TZ hyperplastic nodules (P0.05). The mean AI in epithelium was almost identical to the corresponding PI. In stroma, no apoptotic cells were detectable. There was a significantly higher PI and AI in the glandular epithelial cells in PZ hyperplastic than in TZ hyperplastic nodules, but no difference in PI of the stromal cells between PZ and TZ hyperplastic nodules. There was significantly higher expression of TGFbeta1 and lower expression of EGFR and bcl-2 in PZ than TZ hyperplastic nodules (P0.05). There was no difference in AR expression between PZ and TZ hyperplastic nodules (P0.05).These results indicate that some hyperplastic nodules in PZ might originate from the PZ, and the formation of these nodules might be modulated in a different way from that in the TZ.
- Published
- 2007
20. [A preliminary study of contrast-enhanced ultrasound in benign prostatic hyperplasia]
- Author
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Jie, Tang, Zhi-Li, Wang, Jun-Lai, Li, Yu-Kun, Luo, Wei, Wang, Jian-Hong, Xu, and Huai-Yin, Shi
- Subjects
Aged, 80 and over ,Male ,Regional Blood Flow ,Prostate ,Prostatic Hyperplasia ,Humans ,Reproducibility of Results ,Middle Aged ,Image Enhancement ,Aged ,Ultrasonography - Abstract
To analyze and evaluate the characteristics of benign prostatic hyperplasia (BPH) on contrast-enhanced ultrasound.Forty-eight BPH patients confirmed by transrectal ultrasound-guided biopsy underwent contrast-enhanced ultrasound. Contrast pulse sequencing technique (CPS) and quantitative software-ACQ were used, and the parameters of beginning enhancement time, disappearing and transit time and peak intensity (PI) of the inner gland and outer gland were recorded and analyzed.The prostate was rich with blood and enhanced significantly on contrast-enhanced ultrasound. The beginning enhancement time of the prostatic inner gland, especially the area around the urethra, was much earlier than that of the outer gland, (26.68 +/- 3.76) and (31.24 +/- 5.33) s, respectively (P = 0.000). The contrast disappeared later in the inner gland than in the outer gland, (200.68 +/- 59.40) and (157.56 +/- 50.66) s, respectively (P = 0.000). The transit time of the contrast in the inner gland was much longer than in the outer gland, (173.94 +/- 60.14) and (129.21 +/- 56.91) s, respectively (P = 0.000). PI of the inner gland was much higher than that of the outer gland, (90.45 +/- 42.19) and (65.32 +/- 25.15) dB, respectively (P = 0.000).Contrast-enhanced ultrasound makes it possible to continuously observe the blood perfusion process of BPH, and promises to be an effective means for observing the blood supply in BPH.
- Published
- 2007
21. [Increased lectin-like oxidized low density lipoprotein receptor-1 expression in the autologous vein grafts and vein graft atherosclerosis]
- Author
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Dong, Huang, Jun-bo, Ge, Chun, Liang, Yu-kun, Luo, and Qing-zhe, Jia
- Subjects
Lipoproteins, LDL ,Male ,Disease Models, Animal ,Graft Occlusion, Vascular ,Animals ,Rabbits ,Atherosclerosis ,Scavenger Receptors, Class E ,Transplantation, Autologous ,Veins - Abstract
To study the changes of lectin-like oxidized low density lipoprotein receptor-1 (LOX-1) expression in the autologous vein grafts and vein graft atherosclerotic lesions.Thirty New Zealand white rabbits were randomly assigned to normal control group (rabbits fed with normal diet, n = 10), vein graft group (autologous external jugular vein grafting to common carotid artery and fed with normal diet, n = 10) or vein graft plus high-lipid diet group (autologous vein graft and fed with high-lipid diet, n = 10) for 12 weeks. LOX-1 expressions in the grafts were examined by immunohistochemistry and semi-quantitative reverse transcription-PCR. The relationships between serum total cholesterol level, intimal thickness and LOX-1 expression were also investigated.LOX-1 expression was low in the endothelium of external jugular veins in the normal control group and significantly increased in the endothelium and neointima of vein grafts in the vein graft group (0.31 +/- 0.14 vs. 0.09 +/- 0.04, P0.01) and which was further increased in the endothelium and atherosclerotic lesions in the vein graft plus high-lipid diet group (0.93 +/- 0.34 vs. 0.31 +/- 0.14, P0.01). LOX-1 expression in the atherosclerotic lesions was located both in endothelial cells and foam cells and the expression was most prominent in endothelial cells. LOX-1 expression and intimal thickness were positively related to serum total cholesterol level (P = 0.00 and 0.02) and the partial correlation coefficient was 0.78 and 0.42, respectively.LOX-1 expression is increased in endothelium and neointima of autologous vein grafts of rabbits. Hypercholesterolemia upregulates LOX-1 expression in vein graft atherosclerosis. Thus, LOX-1 might play an important role in the pathogenesis of vein graft atherosclerosis.
- Published
- 2006
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