Sentinel lymph node mapping with computed tomography lymphography for mast cell tumours and a comparison between regional and sentinel lymph node histological status: Sixty-two cases

It is known that the regional lymph node (RLN) may not correspond to the sentinel lymph node (SLN) (the first lymph node draining the tumour), and many diagnostic techniques have recently been aimed at its detection. Although lymphoscintigraphy is the gold standard in both human and veterinary medicine for SLN mapping, it is relatively unavailable in veterinary medicine due to costs and difficult management of the radiotracer. This prospective study evaluated, as a first aim, the feasibility and sensitivity of the computed tomography lymphography (CTL) in detecting the SLN in 62 mast cell tumours (MCTs). The second aim was to evaluate the accuracy of the CTL in identifying the most representative lymph node of the patient's lymphatic status; the histological status of the SNL was compared with that of the RLN, to see in how many cases the patient's stage would have changed according to the RLN. When the RLN turned out to be also the SLN it was decided to excise, as a control LN, the one localised in the neighbourhood of the MCT (neighbouring lymph node; NLN). The detection rate was 90%, with failure of SLN identification in six cases. In 18 (32%) of 56 MCTs with a diagnostic CTL, the SLN did not correspond to the RLN. Forty-five MCTs were surgically removed, together with their corresponding SLN and RLN/NLN. Since the clinical stage of the patient would have changed in only 7% of cases, CTL is a reliable method of detecting the SLN and, for staging purposes, there is no need to remove other LNs.     

A non-inferiority study comparing the ultrasound-guided parasacral with a novel greater ischiatic notch plane approach in canine cadavers

ObjectiveTo describe the gross and ultrasound anatomy of the parasacral region and an ultrasound-guided greater ischiatic notch (GIN) plane approach aimed at staining the lumbosacral trunk (LST) in canine cadavers. To evaluate if the ultrasound-guided GIN plane approach is non-inferior to the previously described ultrasound-guided parasacral approach at staining the LST.Study designProspective, randomized, non-inferiority experimental anatomic study.AnimalsA total of 17 (23.9 ± 5.2 kg) mesocephalic canine cadavers.MethodsAnatomic and echographic landmarks, and the feasibility of performing a GIN plane technique were evaluated using two canine cadavers. The remaining 15 cadavers had each hemipelvis randomly assigned to be administered either parasacral or GIN plane injection of 0.15 mL kg^–1 dye solution. The parasacral region was dissected after injections to assess the staining of LST, cranial gluteal nerve, pararectal fossa and pelvic cavity. The stained LST were removed and processed for histological evaluation of intraneural injections. A one-sided z-test for non-inferiority (non-inferiority margin –14%) was used to statistically evaluate the success of the GIN plane versus the parasacral approach. Data were considered statistically significant when p < 0.05.ResultsThe GIN plane and parasacral approach stained the LST in 100% and 93.3% of the injections, respectively. The success rate difference between treatments was 6.7% [95% confidence interval, –0.6 to 19.0%; p < 0.001 for non-inferiority]. The GIN plane and parasacral injections stained the LST for 32.7 ± 16.8 mm and 43.1 ± 24.3 mm, respectively (p = 0.18). No evidence of intraneural injection was found.Conclusions and clinical relevanceThe ultrasound-guided GIN plane technique resulted in nerve staining that was non-inferior to the parasacral technique and may be considered an alternative to the parasacral approach to block the LST in dogs.     

Lumbosacral plexus block using a combination of ultrasound-guided lateral pre-iliac and parasacral approaches in cats

ObjectiveTo describe an ultrasound-guided lateral pre-iliac (LPI) and parasacral (PS) approach in feline cadavers (phase I) and compare the perioperative analgesic use and complications in cats administered LPI and PS blocks (group PNB) or epidural anesthesia (group EPI) for pelvic limb surgery (phase II).Study designExperimental uncontrolled, anatomic and retrospective cohort study.AnimalsA group of eight feline cadavers and 52 medical records.MethodsBilateral LPI and PS approaches with 0.1 mL kg^–1 of dye to stain the femoral and obturator nerves and the lumbosacral trunk, respectively, were performed on each cadaver. Nerve staining effect was evaluated upon dissections (phase I). Perioperative analgesics use, and complication rates were retrospectively compared between groups PNB and EPI (phase II). Continuous data were compared using the Mann–Whitney U test and the prevalence of events with Fisher’s exact test. Differences were considered significant when p < 0.05.ResultsDissections revealed that the LPI approach stained 94% and 75% of the femoral and obturator nerves, respectively. The PS approach stained 100% of the lumbosacral trunks. Cats enrolled in group PNB (n = 23) were administered lower doses of intraoperative opioids than those in group EPI (n = 25) (p = 0.006). Intraoperative rescue analgesia was required in 60% and 17.4% of cats enrolled in groups EPI and PNB, respectively (p = 0.003). Group PNB required more intraoperative anticholinergics than group EPI (p = 0.02). There were no differences in postoperative pain scores, analgesic use and complication rates.Conclusions and clinical relevanceThe ultrasound-guided LPI and PS approach stained the femoral/obturator nerves and the lumbosacral trunk, respectively, in feline cadavers. Furthermore, PNB was associated with lower intraoperative opioid use and similar postoperative pain and analgesic use compared with epidural anesthesia in a cohort of cats undergoing surgery of the pelvic limb.     

高端牛奶的市场竞争环境分析

在消费升级和国民健康意识的普及趋势下,我国乳制品消费量也逐渐提高,高端牛奶在特仑苏和金典广泛的市场教育下,迎来了稳定增长。牛奶高端化大势所趋,地方品牌在高端市场、超高端市场为消费者提供了更多选择。这一点线下市场尤其明显,线下市场地方品牌的高端奶占据了2/3以上的市场份额,“特金”一统高端市场的时代正在成为过去式。同时,地方品牌的活跃和高端产品的多元化也充分说明统一标准化与天然概念不能兼得。     

沮漳河下游洪水遭遇地区组成规律

漳河水库由观音寺和鸡公尖两个水库以明槽渠道组成，涉及入库洪水的两个来源，而为下游防洪又涉及到与水库坝址至两河口区间及沮河洪水的组成遭遇。沮漳河为长江的一级支流，对长江防洪安全有一定的影响作用，为了确保水库及其下游防护区的安全，必须研究洪水的地区组成，为防洪错峰及安全调度提供设计依据。通过F检验法及t检验法来进行回归方程及相关系数的检验，证明回归方程是显著的，相关也较密切，可用于生产实际。     

Safeguarding Capability Index System of Regional Sustainable Development

According to the new requirement of sustainable development in the new stage, this paper puts forward the definition of the safeguarding capacity of regional sustainable development and uses some statistical methods of frequency statistics and principal component analysis to construct the index system of safeguarding capacity. Then it takes the data of the Three Gorges reservoir area for example to make empirical analysis, and provides efficient measurement tools to further measure the regional sustainability together with its safeguarding capacity, and therefore helps the government and the relevant organizations to establish more scientific policies of sustainable development.     

Performance Analysis of MIPv4 Regional Registration Combined with Low Latency Handoffs

The mechanism of MIPv4 regional registration and the low latency handoff protocols are introduced. Ways and procedure of pre-registration handoff and post-registration handoff are discussed also. The authors analyze the performance of the low latency handoff protocols combined with low latency handoffs over a wireless access based on IEEE 802. 11 standard in a tree-like network topology. The performance of pre-registration and post-registration scheme is given by simulation.