Objective To evaluate MR findings and clinical features in patients with spontaneous spinal epidural hematoma (SSEH). Methods Eight patients (5 men, 3 women; aged 16-50 years ) with SSEH underwent MR imaging during 1994-2001, including 7 cases without history of trauma or coagulation disorders and 1 case with history of hypertension. MR imaging was performed from 4 hours to 3 days after the onset of symptoms in all 8 patients with surgical and pathologic diagnosis. Results The hematomas were in lateral posterior or posterior epidural space, including 3 cases in cervical vertebra, 2 cases in thoracic vertebra, 2 cases in cervical and thoracic junction region, and 1 case in thoracic and lumbar part. The MRI confirmed an encapsulated hematoma caused by arteriovenous malformation in 1 case and two hematomas associated with disc herniation. The signal intensity of the hematoma varied with the hematoma age, but T 1-weighted images reflected its typical signal changes. Sagittal and coronal T 1- weighted images revealed isointense (7 cases) and slight high-intense (1 case) signal; Sagittal and axial T 2-weighted images revealed mixed-intensity (6 cases) and mixed high-intensity (2 cases). Conclusion MR imaging has an important value on localization, identification, and differential diagnosis of the lesion, therefore, it is the most helpful diagnostic tool for this condition.

Objective To compare the effects and complications of lumboperitoneal shunt ( LP ) and ventriculoperitoneal shunt ( VP ) in the treatment of post?traumatic hydrocephalus. Methods Eighty patients with post?traumatic hydrocephalus treated in the neurosurgery department of Zhangjiagang Hospital of Traditional Chinese Medicine from March 2014 to March 2010 were retrospectively analyzed. The patients were randomly divided into two groups,40 patients treated with LP were assigned into the LP group and 40 patients undergone VP treatment were seen as the VP group. All patients were followed up for 1 year to investigate and compare the symptom improvement rate,neurological deficit score and the incidence of complication of the two groups. Results The total effective rate of hydrocephalus disappearance in the LP group was 41. 50% ( 37/40) and 87. 50%( 35/40) in the VP group. The difference between the two groups was not statistically significant (χ2=0. 556,P=0. 456);the neurological deficit scores before treatment in the LP group and VP group were (28. 35±8. 64) points and (29. 13±7. 98) points,there was no significant difference between the two groups (t=0. 419,P=0. 676) . The difference in the scores of neurological deficit after treatment in the LP and VP group was not statistically significant ( (19. 32±5. 34) points vs. (21. 62±4. 86) points,t=1. 480,P=0. 143),the average scores of neurological deficits in the two groups were significantly better than those before treatment ( t=5. 623, 5. 084,P<0. 001 ) . There was no significant difference in the average score of improvement of urinary incontinence between the two groups before and after treatment ( t=0. 376,1. 265,P>0. 05) ,the average score of urinary incontinence improvement after treatment in both groups were better than those before treatment ( t=4. 891,5. 370,P<0. 001) . In the LP group,the incidence of bleeding,infection,shunt related complications and shunt abnormality were all 2. 50% ( 1/40 ) , the overall complication rate was 10. 00%, the incidence of bleeding,infection,shunt related complications and shunt abnormality in the VP group were 7. 50% (3/40), 10% ( 4/40 ) , 5% ( 2/40 ) 10%, ( 4/40 ) , the overall complication rate was 32. 50%, there was significant difference between the two groups (χ2=6. 050,P=0. 014) . Conclusion LP and VP have significant curative effect on the treatment of post?traumatic hydrocephalus,but the overall incidence of LP complication after 1 year is significantly lower than that of VP,and is worth popularizing widely in clinical practice

Carcinoma, Papillary ; diagnosis ; pathology ; Female ; Humans ; Jugular Veins ; pathology ; Male ; Middle Aged ; Neoplastic Cells, Circulating ; Retrospective Studies ; Thyroid Neoplasms ; diagnosis ; pathology

OBJECTIVETo study the molecular action mechanism of active constituents desoxyrhaponticin (DES) and human serum albumin (HSA).

METHODUnder the simulated physiological condition, computer analog technology, fluorescent spectrometry and ultraviolet spectrum were combined to study the binding mechanism between drug and protein.

RESULTMolecular modeling was adopted to establish the binding model between DES and HSA, suggesting that the interaction force maintaining drug and protein is mainly the hydrophobic interaction with a hydrogen-bond interaction. The results from spectroscopy indicated that the interaction between DES and HSA is a dynamic binding process with a high intensity. The value of the binding distance (r) between DES and HSA was low, which demonstrate the occurrence of energy transfer. DES made an impact on HSA' structural domain microcell conformation, which resulted in hydrophobic changes in binding areas. According to the fluorescent phase diagram technical analysis, the changes in the DES-HSA reaction conformational pattern showed a "two-state" model. According to the obtained thermodynamic parameters for the DES-HSA interaction, the interactional force between DES and HSA was mainly a hydrophobic interaction. The fluorescence polarization proved that a non-covalent compound was generated during the interaction between DES and HSA.

CONCLUSIONThe spectrum experiment showed consistent results with the computer analog technology, which could provided certain reference for studies on the interaction between DES and HSA.

Humans ; Models, Molecular ; Protein Binding ; Protein Conformation ; Serum Albumin ; chemistry ; metabolism ; Spectrometry, Fluorescence ; Spectrophotometry, Ultraviolet ; Stilbenes ; metabolism ; Thermodynamics

The performance evaluation is an effective method to guide the public hospitals behavior and pro-mote their sustainable development.The introduction of disease severity could make the performance evaluation sys-tem more scientific and reasonable, and encourage the hospitals to improve their technical skills and services ability. Based on the Shanghai diagnosis related groups system, a case-mix index ( CMI) was introduced and a severity score of disease was developed after the relative weight ( RW) adjustment to evaluate different types of disease severity in hospitals.The results have shown that CMI effectively reflects the patients'disease severity and the intensity of treat-ment in those hospitals taken into consideration.Therefore, the scientific indicators should be selected and the evalu-ation system should be improved thereby establishing an effective monitoring and dynamic adjustment mechanism and further developing the diagnosis related group application.

OBJECTIVETo study the therapeutic effects of posterolateral depression fractures of the tibial plateau through a modified anterolateral approach.

METHODSFrom February 2011 to January 2012,13 patients with posterolateral depression fractures of the tibial plateau were treated through a modified anterolateral approach. There were 8 males and 5 females, ranging in age from 28 to 59 years old (49.2 years old on average). Data from patients were collected retrospectively as follows: X-ray, time of fracture healing and the complications of fracture healing. The patients were evaluated both clinically and radiologically according to the Rasmussen score system.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 18 months (mean 13.7 months). All the patients got bony union. The average radiographic bony union time was 15.1 weeks (ranged, 11 to 17 weeks). No case of secondary articular depression was found. No complications such as malunion or joint stiffness were found. But 1 patient had superficial infection and 1 patient had common peroneal nerve injury. According to the Rasmussen score system,the mean radiological score was 16.50 ± 0.67 (ranged, 13 to 18), and the mean functional score was 25.20 ± 2.21 (ranged, 13 to 30). The mean range of knee motion was (125.3 ± 9.3)° (ranged, 0° to 135°).

CONCLUSIONTreatment of depression fractures of posterolateral tibial plateau with a modified anterolateral approach is a safe method with effective exposure, due to its stable fixation and relatively good outcome with minimal soft-tissue complications. It is regarded as an ideal procedure for depression fractures of posterolateral tibial plateau.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery

China ; History, 20th Century ; History, 21st Century ; Pathology ; Periodicals as Topic ; history

Animals ; Antineoplastic Agents ; administration & dosage ; Delayed-Action Preparations ; administration & dosage ; Drug Carriers ; chemistry ; Drug Delivery Systems ; Growth Hormone-Releasing Hormone ; administration & dosage ; Nanotechnology ; Research

Objective To explore expression of hypoxia inducible factor-1?(HIF-1?)in kidney cells during hypoxia/reoxygenation injury,and to study the effect of Danshen on prevention of the hypoxia/reoxygenation injury to cells.Methods Human renal proximal tubular cells(HK-2)were used as the target cell.There were 3 groups:control group,model group,Danshen group.hypoxia/reoxygenation models after neonatal asphyxia were established with liquid paraffin covering method.Expression of HIF-1? were detected with strcp avidin biotin complex(SABC)immunohistochemistry at following different time points:hypoxia 1,4,8,12,24 h,which means 1,4,8,12,24 h respectively after hypoxia;and hypoxia/reoxygenation 1,4,8,12,24 h,which means 1,4,8,12,24 h respectively after hypoxia/reoxygenation.Results HIF-1? was expressed mainly in HK-2's nucleus.There had low expression of HIF-1? in HK-2 cells under the normal culture,and its expression level kept rising quickly during hypoxic/reoxygenatic culture,until 4 h after the beginning of reoxygenation.Compared with the study group,the expression level of HIF-1? in HK-2 cells of the Danshen group were significantly lower at different time points(Pa

OBJECTIVE: To investigate the clinical application and efficacy of ¹²⁵Ⅰ radioactive seeds implantation in the treatment of recurrent salivary gland carcinoma after external radiotherapy. METHODS: From July 2004 to July 2016, 43 cases of recurrent salivary gland carcinoma of the neck after external radiotherapy or surgery combined with external radiotherapy were treated. According to the conventional segmentation radiotherapy for head and neck cancer (once a day, 1.8-2.0 Gy each time, 5 days per week), the cumulative radiation dose of the patients in this group was calculated. In the study, 26 patients received 50-60 Gy, 7 patients received less than 50 Gy, 4 patients received 60-70 Gy, and 6 patients received more than 80 Gy (range: 80-120 Gy). The interval between the last external irradiation and local recurrence was 4-204 months, and the median interval was 48 months. Among them, 25 cases were treated with ¹²⁵Ⅰ radioactive seeds implantation only and 18 cases were treated with ¹²⁵Ⅰ radioactive seeds implantation after operation. The prescription dose was 100-140 Gy. The control rate, survival rate and disease-free survival rate were recorded to evaluate the side effects. RESULTS: The median follow-up time was 27 months (ranging from 2.5 to 149.0 months). Among them, the median follow-up time of adenoid cystic carcinoma patients was 31 months (range: 2.5-112.0 months), and the median follow-up time of mucoepidermoid carcinoma patients was 18 months (range: 5-149 months). The local control rates for 1, 3 and 5 years were 66.5%, 48.8% and 42.7%, respectively. The 1-, 3- and 5- year survival rates were 88.0%, 56.7% and 45.8%, respectively. The disease-free survival rates of 1, 3 and 5 years were 58.3%, 45.4% and 38.1%, respectively. There was no statistically significant difference in local control rate, survival rate, and disease-free survival between the radioactive seeds implantation group and the radioactive seeds implantation group after surgical resection. There were 2 cases of acute radiation reaction Ⅰ/Ⅱ and 3 cases of reaction Ⅲ or above. In the late stage of radiotherapy, there were 8 cases with Ⅰ/Ⅱ grade reaction and 3 cases with Ⅲ grade or above reaction. The incidence of radiation reactions of Grade Ⅲ and above was 7%. CONCLUSION ¹²⁵Ⅰ radioactive seeds implantation provides an alternative method for the treatment of recurrent salivary gland carcinoma after external radiotherapy. The local control rate and survival rate are improved on the premise of low incidence of side effects.
Brachytherapy/adverse effects* ; Humans ; Iodine Radioisotopes/therapeutic use* ; Neoplasm Recurrence, Local/radiotherapy* ; Salivary Gland Neoplasms/radiotherapy* ; Salivary Glands