Endoscopy ; Humans ; Myringoplasty ; Tympanic Membrane ; Tympanic Membrane Perforation ; surgery ; Wound Healing

Objective: To investigate the surgical methods and outcomes of the enlarged translabyrinthine approach in the removal of large acoustic neuromas. Methods: A large mastoidectomy involved complete exposure of the sigmoid sinus, the dura behind the sinus for at least 1 cm, the superior petrosal sinus and the middle fossa dura. The jugular bulb was exposed and pressed downwards if necessary. The internal auditory meatus was skeletonized and uncovered for at least 270°.The debulking of the tumor began inside the anterior and inferior poles in order to find the brainstem and the facial nerve root as early as possible, and then the dissection of the nerve was done medially to laterally. Intraoperative facial nerve monitoring and postoperative CT and MRI were done in all cases. Results: Total removal was achieved in all 18 patients with tumors larger than 3 cm (mean size: 4.2 cm). There were no deaths or other complications such as intracranial infection and persistent cerebrospinal fluid leakage. There were no obvious cerebral sequelae. The facial nerve was preserved both anatomically and functionally in 14 cases, with Grade Ⅰ or Ⅱ in 8 cases, Grade Ⅲ or Ⅳ in 6 cases. Nerve interruption occurred in 4 patients who all had severe facial palsy or nerve interruption before operation. Sixteen patients resumed work within 1-3 months. Conclusion: Total removal of large acoustic neuroma could be acomplished via the translabyrinthine approach, with good preservation of facial nerve function and minimum incidence of morbidity.

Objective: To investigate the relationship between right ventricular (RV) glucose metabolism by18F-fludeoxyglucose positron emission tomography (18F-FDG PET) and right heart function in patients with dilated cardiomyopathy (DCM).
Methods: The18F-FDG PET imaging was performed in 34 consecutive DCM patients, with the reference of Herrero method, the corrected RV standard uptake value (cRVSUV), corrected left ventricular standard uptake value (cLVSUV) and the ratio of RV to LV SUV (cR/L) were obtained. And all 34 patients received cardiac magnetic resonance imaging (cMRI) examination within 7 days, the left ventricular ejection fraction (LVEF) and RVEF were automatically calculated with Simpson’s principle. The pulmonary arterial systolic pressure was measured by echocardiography.
Results: The corrected cRVSUV and cR/L by18F-FDG PET were negatively related to RVEF by cMRI, (r=-0.513, P<0.01) and (r=-0.463,P<0.01) respectively, and meanwhile, the corrected cRVSUV and cR/L were also negatively related to LVEF, (r=-0.387,P<0.01 andr=-0.362,P<0.01) respectively.
Conclusion: Increased RV glucose metabolism closely related to RV dysfunction, the18F-FDG uptake value by PET might be used as an index for assessing the right heart function and prognosis in DCM patients.

AIM: To investigate the effects of calcitonin gene-related peptide (CGRP) on cultured anoxic-reoxygenation human umbilical vein endothelial cells. METHODS:In the present experiment, an anoxic-reoxygenation model was established by using cultured human umbilical vein endothelial cells. The uptake rate of trypan-blue and calcium and magnesium contents of endothelial cells and lactic dehydrogenase (LDH) activity in medium and malondialdhyde (MDA) content of endothelial cells were measured 60,120 and 180 min after anoxia and 30 and 60 min after reoxygenation, and the effects of 1?10 -8 mol/L CGRP on anoxic-reoxygenation endothelial cells were studied. RESULTS: The findings showed that, as anoxia prolonged, the uptake rate of trypan-blue and LDH activity and MDA content gradually elevated and, during reoxygenation, these parameters sharply increased. Calcium and magnesium levels gradually declined as anoxia prolonged, and during reoxygenation calcium content significantly increased. Meanwhile, 1?10 -8 mol/L CGRP might significantly reduce the uptake rate of trypan-blue and LDH activity and MDA content during anoxia and reoxygenation and lessen the increase in calcium content and the loss of magnesium during reoxygenation. CONCLUSION: These results showed that CGRP might have a direct protective function to endothelial cells afflicted with anoxic-reoxygenation injury by inhibiting lipid peroxidation, attenuating calcium overload and loss of magnesium and enzyme.

Objective To explore the relationship between hypothyroidism and myocardial injury in patients with idiopathic dilated cardiomyopathy (IDC) by 99Tcm-MIBI SPECT/18 F-FDG PET and late-gadolinium enhancement cardiac magnetic resonance imaging (cMRI-LGE).Methods Sixty-three consecutive patients (42 males and 21 females,(52±11) years) with IDC were enrolled from October 2010 to December 2012.Serum TT3,TT4,FT3,FT4 and TSH were determined using a fully automated chemiluminescence immunoassay.All patients underwent 99Tcm-MIBI myocardial perfusion SPECT/18F-FDG myocardial metabolism PET imaging and cMRI-LGE.Seventeen segments model was used for segmental analysis.Patterns of perfusion/metabolism were classified as normal,mismatch,mild-to-moderate match and complete match.cMRI-LGE was classified into 3 categories (non-LGE,mid-wall LGE and transmural LGE).x2 test was used for data analysis.Results All patients were divided into euthyroid group (n =53) and hypothyroidism group (n =10) according to the levels of serum thyroid hormones.The percentage of normal perfusion/metabolism segments in the euthyroid group was apparently higher than that in the hypothyroidism group:71.8％ (647/901) vs 57.6％ (98/170),x2 =13.50,P＜0.001 ; whereas the percentage of perfusion/metabolism mismatch segments in the euthyroid group was significantly lower than that in the hypothyroidism group:17.8％ (160/901) vs 31.2％ (53/170),x2=16.20,P＜0.001.The euthyroid group had a higher percentage of non-LGE segments (88.0％ (793/901) vs 69.4％ (118/170),x2 =35.70,P＜0.001) and a lower percentage of mid-wall LGE segments (4.8 ％ (43/901) vs 24.1％ (41 / 170),x2 =74.70,P＜ 0.001) compared to hypothyroidism group.Conclusions Hypothyroidism has a detrimental effect on myocardium.99Tcm-MIBI SPECT/18F-FDG PET imaging is sensitive in detecting viable/ischemia myocardium,and cMRI-LGE is good at detecting moderate fibrosis.Combining SPECT/PET imaging and cMRI-LGE for assessing myocardial injury would provide more comprehensive information.

BACKGROUND: Naloxone has a significant arousal effect on many types of comas. It is usually believed that this is because its inhibition on endogenous opioid peptides. But depth of coma is not necessarily positively correlated to endorphin (EP).OBJECTIVE: Based on existing findings on direct stimulating effect of naloxone on cerebral cortex, further studies need to be done to explore whether it is dose-dependent or not.DESIGN: Single-factor design based on cells.SETTING: Neurology department in a university hospital and the neurology department in a hospital of a military medical university of Chinese PLA.MATERIALS: This study was completed in the Laboratory Center of Tongji Medical College, Huazhong University of Science and Technology. Thirty healthy new born Wistar rats, regardless of their gender, aging 8 - 12 days and weighing 150 -250 g, were selected.METHODS: The experiment was performed at room temperature. The perfusion slot were placed on the microscope stage, and cells with smooth surfaces, triangle or pyramidal shapes, strong refraction and more than one neurites were selected for patch clamp experiment. Patch clamp whole-cell recording technique was used to measure the pyramidal cells of the frontal lobe immediately after separated from the Wistar rats, and to investigate the fluctuations of their membrane potential of cerebral cortex neurons and the frequencies of their spontaneous electric activities after administration of naloxone at different doses.MAIN OUTCOME MEASURES: The neural excitatory reaction rate, depolarization amplitude and increasing rate of spontaneous electric activities after administration of different doses of naloxone were selected as main outcome measurements.RESULTS: The excitatory reaction rates of cerebral cortex neurons immediately after separation to doses of naloxone(100, 50, 10, 1, 0. 1 μmol/L)were 83%, 67%, 86%, 71% and 33%; while the depolarization amplitude of them were 9. 8, 9.6, 8.4, 5.2 and 1. 3 mV respectively; and the corresponding spontaneous electric activity were increased by 587% , 375% ,291%, 125% and 69%.CONCLUSION: Naloxone can induce excitatory reactions in cerebral cortex neurons directly, and the reactions have proved to be dose-dependent.

Objective To evaluate the efficacy of MRI for assessment of re-distribution of bone marrow mesenchymal stem cells injected intramyocardially in main organs (heart, liver, spleen and kidney) under different heart status (beating or arresting) in a porcine model. Methods Bone marrow-derived mesenchymal stem cells were obtained from the male swine and labeled with iron oxide during culture. Acute myocardial infarction was created in female swine, one week later, the survivors were randomly divided into 4 groups. Cardiopulmonary bypass was set up to arrest the heart, and then labeled cells (1×108) were intramyocardially injected into the border of the infracted myocardium in group 1 (n=6). The same volume of cells was grafted into the beating heart in group 2 (n=6). In group 3 and 4, saline was injected into either the arresting or beating myocardium. Three days later, re-distribution of stem cells and cardiac function were assessed by T2*WI and cine MRI, respectively. All animals were sacrificed for histology and real-time quantitative polymerase chain reaction (RT-PCR) of sex-determining region on Y-chromosome (SRY) investigation.The ANOVA and t test was used for statistics. Results The left ventricular end-diastolic volume (LVEDV) before transplantation for group 1-4 were: (56.8±5.3),(54.8±6.8),(57.4±4.3)and(56.8±2.8) ml, and after transplantation for group 1-4 were: (65.2±5.2),(63.2±3.7),(60.2±4.7)and(62.2±4.4) ml. The left ventricular end-systolic volume (LVESV) before transplantation for group 1-4 were: (33.5±7.6),(32.3±5.3),(33.5±3.6)and(32.7±4.6) ml,and after transplantation for group 1-4 were: (37.3±5.6),(36.3±6.9),(34.3±5.4)and(36.3±8.1) ml. The left ventricular EF values (LVEF) before transplantation for group 1-4 were: (42.3±7.2)%,(41.7±6.8)%,(41.8±8.6)% and(42.7±7.7)%,and after transplantation for group 1-4 were: (44.5±8.7)%,(43.1±7.4)%,(42.8±5.6)% and(43.3±8.4)%. The myocardial infarction area (MI) before transplantation for group 1-4 were: (6.5±2.1),(6.4±1.9),(6.5±2.5)and(6.4±2.6) cm2,and after transplantation for group 1-4 were: (6.4±2.3),(6.2±2.6),(6.3±2.5)and(6.4±2.8) cm2 . There were no statistical differences before and after transplantation in these 4 groups[P values of before and after transplantation for LVEDV, LVESV, LVEF,MI were >0.05 (F= 0.277, 0.066,0.066, 0.003); and >0.05 (F= 1.137,0.182,0.021,0.008),respectively]. The T2 value of the infracted myocardium in group 1 decreased more obviously than that in group 2[(-22.3 ± 2.2) vs (-17.0 ± 0.8) ms, t=-5.489, P＜0.01], while the T2 value of the spleen decreased more significantly in group 2 than that in group 1[(-7.7 ± 0.7) vs (-13.3 ± 1.1) ms,t=9.055, P＜0.01]. The T2 values of the liver and kidney were no significant differences in group 1 and 2 (liver, t=-0.532,P>0.05 and kidney, t=-0.113,P>0.05). The results of RT-PCR in group 1 and 2 showed significant differences in heart[(150±62) vs (72±4) U/L ,P<0.05, t=3.109], spleen[(131±1) vs (233±17) U/L, P＜0.01, t=- 13.286]and liver[(17±1) vs (9±5) U/L ,P<0.01,t= 3.492]. Pathological examination demonstrated that the transplanted stem cells were positive for Prussian blue staining, which had a good correlation with MRI results. Conclusion MRI can serve as a convenient and efficient imaging method to track the migration of stem cells with SPIO labeled in early stage and evaluate its early re-distribution in vivo. Injection of bone marrow mesenchymal stem cells in the arresting heart could favor retaining more cells in the myocardium.

OBJECTIVE: To study cellular immune function of palatine tonsil B lymph cell. METHOD: The phenotype of palatine tonsil cells (PTC) and that of peripheral blood mononuclear cell (PBMC) were compared using fluorescence staining and flow cytometry (FCM) analysis, then immunomagnetic beads were used to separate CD3- cell in PTC and PBMC. The proliferation function of CD3- lymph cell of PTC and PBMC was tested after stimulated by CD20mAb. RESULT: FCM analysis founding that 71.2% PTC express CD20 with higher mean fluorescence intensity, MFI, compared to the 15.5% in PBMC. There's no significant difference between the proliferation of PTC and PBMC B lymph cell. CONCLUSION CD20 expression is different in PTC and PBMC, but corresponding function is still unknown.
Adult ; Antigens, CD20 ; metabolism ; B-Lymphocytes ; cytology ; immunology ; metabolism ; Flow Cytometry ; Humans ; Palatine Tonsil ; cytology ; immunology

OBJECTIVE: To explore the effect of septoplasty on the modality of inferior turbinate in patients with a deviated nasal septum. METHOD: Twenty-three patients with nasal septum deviation underwent septoplasty without turbinate surgery. All patients underwent CT imaging scans before and 3 months after the surgery. The thicknesses of the medial mucosa, lateral mucosa,and the cross-sectional areas of the inferior turbinate were measured and compared using the Wilcoxon signed rank test. P<0. 05 was considered statistically significant. RESULT: On the concave side of the septum, the thickness of the medial mucosa of the inferior turbinate was(5. 3+/-1.5) mm to (4. 1+/-1. 2) mm (P<0. 05), the thicknesses of the lateral mucosa of the inferior turbinate was(2. 5+/-0. 9) mm to (2.0+/-0. 9) mm (P>0. 05), and the cross-sectional area of the inferior turbinate was(139. 8 +/- 35.6) mm2 to( 110. 3 +/- 22.6)mm2 (P<0.05), pre- and post-operatively. On the convex side of the septum , the thickness of the medial mucosa of the inferior turbinate was(1.0 +/- 0. 6) mm to(4. 3 +/- 0. 6) mm (P>0. 05), the thicknesses of the lateral mucosa of the inferior turbinate was(1. 9+/-1. 1) mm to (1. 9+/-1.3) mm (P>0. 05), and the cross-sectional area of the inferior turbinate was(104. 5+/-15. 8)mm2 to(108. 3 +/- 20. 8)mm2 (P>0. 05), pre- and post-operatively. CONCLUSION The compensatory hypertrophic inferior turbinate may be self-adaptability in modality soon after septoplasty, thus surgeons must take it into consideration before performing turbinate surgery.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; surgery ; Rhinoplasty ; Tomography, X-Ray Computed ; Turbinates ; diagnostic imaging ; Young Adult

ObjectiveTo investigate reproducibility of cardiac MRI for assessment of cardiac morphology and ventricular function in selected normal Chinese Han population.MethodsTwo hundred and sixty-nine normal volunteers underwent cardiac MRI using a 1.5 T MR system.HASTE and steady state free precession imaging were performed with long and short axis images and cine mode through the ventricle with wireless vector cardiac gating.The images were reviewed by two independent observers.The dimensions of cardiac chambers and ventricular function including ejection fraction (EF),end diastolic volume( EDV),end systolic volume (ESV) and myocardial mass were evaluated.The data between male and female were compared by using two-tailed unpaired t test.Results Total imaging time was (15 ± 3 ) min.The anteroposterior diameter of the left atrium was( 2.87 ± 0.77 ) cm,the right atrial diameter perpendicular to the atrial septum was ( 3.61 ± 0.57 ) cm,the end diastolic diameter of the left ventricle was (4.97 ±0.52) cm,the end diastolic diameter of the right ventricle was (2.65 ± 0.48) cm.On the left ventricle,EF was(60.62 ±7.08)％,EDV was (115.37 ±26.71) ml,ESV was (46.02+15.72) ml and LV mass was ( 82.97± 24.03 ) g.On the right ventricle,EF was (47.73 ± 6.50 ) ％,EDV was ( 128.27 ± 32.16 )ml,ESV was (67.7 ± 21.07) ml and RV mass was (48.24 ± 13.42) g.There were no statistically significant differences in LVESV( P =0.144 ),LVEDV index ( P =0.714 ),LVESV index ( P =0.113 ),LVCI ( P =0.199),RVEF ( P =0.296 ) and RV mass ( P =0.093 ),and statistically significant differences in other cardiac parameters between male and female.Conclusion Cardiac MRI can provide useful information about cardiac function and morphology with a high level of reproducibility in normal Chinese Han population.