The circle of Willis is the major cerebral collateral circulation.Its anatomical variation is in populations higher.The previous studies showed that anatomical variation in circle of Willis was an independent risk factor for cerebral ischemia.This article reviews the relationship between the various anatomical variation types of the circle of Willis and cerebral ischemia.

AIM To observe protective effects of doxepin on focal cerebral ischemia-reperfusion(I-R)injured rats. METHODS 120 rats were randomly divided into ischemia-reperfusion group,doxepin, nimodipine group and sham-operated group respectively, ischemia-reperfusion model was made by using the suture emboli method, the content of NO and MDA, activities of NOS and SOD in the cerebral tissues and the intracellular [Ca 2+ ] i in the cerebral cortex were determined respectively. RESULTS The content of NO, MDA and [Ca 2+ ] i and the activities of NOS decreased and the activities of SOD increased significantly in the doxepin and nimodipine group compared with ischemia-reperfusion group respectively(P

Purpose:To study the efficacy and the toxic side effects of high dose epirubicin containing combination regimen in the treatment of advanced breast cancer. Methods:16 patients with advanced breast cancer were treated with epirubicin (EPI) 100 mg/m 2,CTX 600 mg/m 2,5 FU 500 mg/m 2,every 21 days,Each patient was given at least 2 cycles. Results:There were 2 CR and 9 PR, the overall response rate was 68.8% (11/16). Main side effects were grade Ⅰ—Ⅱ leucopenia, nausea and vomitting, alopecia.Conclusions:This study confirmed that combination chemotherapy with high dose epirubicin is a safe and effective regimen for patients with advanced breast cancer and is worthy of further clinical trial.

Objective: The effect of oil of Hippophae rhamnoides (OHR) supplements on sGOT,metabolism of free radical and ultrastructure of myocardium was observed in mice.Methods: 70 male ICR mice were randomly divided into six groups: sedentary control group (SCG), sedentary+OHR group (SHG), immediately after exhaustive exercise in control group (IEC) and in OHR group (IEO), 24 hours recovery after exhaustive exercise in control group (REC) and in OHR group (REO). After 6 w swimming program with gradually increasing intensity, these mice carried out an exhaustive swimming before sacrifice. Serum GOT, SOD and MDA in myocardium were measured and the changes of ultrastructure of myocardium were observed by transmission electron microscope (TEM). Results: 1) Serum GOT was significantly different among these groups except between SCG and SHG, IEC and REC. 2) SOD was significantly different among the above groups except between SCG and SHG, IEO and REO. 3) The concentration of MDA was significantly different among the above groups except between IEC and IEO, REC and REO. 4) The integrity of mitochondrion, rough surfaced endoplasmic reticulum and myofilament in myocardium was better in OHR groups than in control groups and the pathological tendency of these ultrastructures was lighter in OHR groups compared with control groups. Conclusion: OHR supplementation can reduce the damage of myocardium caused by exercise and enhance antioxidative status of myocardium; OHR supplementation can protect the ultrastructure of myocardium.

Objective To evaluate the CT features and the role of CT in the diagnosis of Crohn′s disease. Methods CT manifestations of 18 patients with pathology confirmed Crohn′s disease were retrospectively analyzed. The majority of the patients were scanned with spiral CT or multidetector row CT.Results All 18 patients, segmental thickening of the bowel wall was detected. There were two different appearances in contrast-enhanced CT scans: (1) mural thickening without enhancement or mural stratification, and homogeneous attenuation in the thickened wall were observed in 7 patients; (2) mural thickening and stratification, resulting in the target or double-halo appearance, were detected in 11 patients, and the bowel wall thickening ranged from 5 to 10 mm. Nine patients had perienteric abnormalities including fibrofatty proliferation, phlegmon and mesenteric hypervascularity. According to the CT manifestations, 5 patients were initially diagnosed as other diseases including intestinal obstruction (1 case), tuberculosis (1 case), cancer (2 cases), and abscess (1 case), respectively. Conclusion CT has the unparalleled ability to depict the abnormalities in the bowel wall, mesentery, abdominal and pelvic viscera, and contrast-enhanced CT can distinguish active Crohn′s disease from quiescent Crohn′s disease. These features make CT particularly valuable in the management of Crohn′s disease.

Humans ; Non-alcoholic Fatty Liver Disease

Objective To improve recongnition of CT manifestations and value in diagnosing aortic dissection and rupture.Methods The CT plain and enhanced findings in 16 cases with aortic dissection were analyzed retrospectively,these 16 cases were classified in to DeBakey type Ⅰ?Ⅱand Ⅲ in 2,4 and 10,in which 3 cases had subacute and chronic rupture.Results Among these 16 patients with AD,the aortic double lumen and intimal flap,6 cases were showed minor calcifications in the dissection membrane,3 cases were acute rupture or slow leakage complications including periaortic mediastinal,pericardiac pleural or retroperitoneal effusion and retroperitoneal diffuse fibrosis.Conclusion CT is a helpful reliable and rather simple technique for AD lesion and complication.It should be suggested if a diffuse fibrosis occure in retroperitoneal space complicating with chronic permeability of AD.

Objective To investigate the outcome of the urethral realignment simultaneous internal fixation in treatment of pelvic fracture associated with posterior urethral disruption. Methods The study included 33 patients with pelvic fracture associated with posterior urethral disruption treated simultaneously by urethral realignment and internal fixation from December 2003 to August 2009. According to AO classification, two patients were with type A2 fracture, six with type B1 ,seven with type B2,five with type B3 ,six with type C1 ,four with type C2 and three with type C3. All the patients were found with complete posterior urethral disruption. Primary urethral realignment combined with emergency open reduction and internal fixation of pelvic fracture were performed in 12 patients. Due to unstable condition, 21 patients underwent primary suprapubic cystostomy and external fixation, sequentially delayed urethral realignment and internal fixation.Results The mean follow-up time of all patients was 37 months ( range, 3-63 months). Of all the patients, 25 patients (76%) regained good without urethral dialation or needed only short term urethral dilatation, and eight patients (24%) suffered from urethral stricture and needed further complex surgery. The incidences of urinary incontinence and erectile dysfunction were 6%(2/33) and 18% (6/33). The erectile dysfunction of two patients was ascribed to sacral nerve injury.At the final follow-up, the mean score was 90.3 points (range, 66-100) according to the Majeed' s scoring system, which showed that the result was excellent in 24 patients, good in eight and fair in one.Conclusions Urethral realignment and simultaneous internal fixation can attain good clinical results for pelvic fracture associated with posterior urethral disruption. It takes advantages of minor surgical trauma,short treatment cycle, good outcome and low complication rate.

Objective To summarize the clinical experience of diagnosis and arthroscopic treatment of intratment of intra ular osteoid osteoma.Methods Seven patients(average 22.4 years old with range from 11～32 years)with intra-articular Osteoid osteoma who underwent arthroscopy treatment from March 2006 to June 2009 were studied respectively.Thin-section CT scanning was used to confirm diagnosis and determine surgery location.Results The time span between the appearance of clinical symptoms and confirmed diagnosis was 26.0 months on average(range from 18 to 36 months).At a mean 19-month follow-up,all patients showed significant improvements including VAS decrease,no recurrence,pain relief and normal range of motion.Conclusion The atypical clinical features and radiographic findings of osetoid osteoma might lead to the delayed diagnosis.Using arthroscopy to remove intro-articular osteoid ostema was a safe and effective way.

Objective To investigate clinicopathological features of scalp angiosarcoma, and to analyze the relationship of tumor stage and treatment with prognosis. Methods Clinical and follow-up data were collected from 16 patients with non-metastatic primary scalp angiosarcoma treated in the Department of Plastic and Reconstructive Surgery of Zhongda Hospital, Southeast University from September 2002 to June 2013. According to the seventh edition American Joint Committee on Cancer (AJCC)TNM staging system for soft tissue sarcomas (2010), staging of scalp angiosarcoma was performed for the 16 patients. Statistical analysis was carried out by the Kaplan-Meier method for survival rates and by the Log-rank test for survival curve. The Cox regression model was used for multivariate regression analysis. Results Of the 16 patients, 4 had stageⅠangiosarcoma, 4 stage Ⅱangiosarcoma, and 8 stage Ⅲ angiosarcoma. The tumor usually began as ecchymosis-like lesions on the head or face in early stage, and progressed into dark red infiltrative plaques, nodules and ulcers which easily ruptured and bled in later stage. Histopathological examination showed generalized vascular proliferation and infiltration with high histological morphological diversity. Cytologic atypia was commonly seen. The median time to recurrence was 15 months, and local recurrence occurred in 7 patients. The median time to metastasis was 20.5 months, and distant metastasis was observed in 8 cases, including 4 cases of pulmonary metastasis, 2 lymph node metastasis, 1 liver metastasis and 1 bone metastasis. The survival time was 33.0 ± 4.4 months (median, 32 months)in 4 patients with stage Ⅰangiosarcoma, 24.0 ± 7.9 months(median, 15 months)in 4 patients with stage Ⅱangiosarcoma, and 23.9 ± 3.9 months (median, 24 months)in 8 patients with stage Ⅲ angiosarcoma. Additionally, the survival time was 23.4 ± 5.2 months(median, 21 months), 24.4 ± 5.7 months(median, 24 months)and 35.8 ± 9.7 months(median, 26 months) in 5 patients receiving surgical treatment alone, 7 patients receiving surgical treatment and radiotherapy, and 4 patients receiving surgical treatment, radiotherapy and immunotherapy, respectively. Conclusions Surgical treatment combined with radiotherapy and immunotherapy may serve as the first-choice treatment for scalp angiosarcoma. Tumor size and treatment regimens are main factors influencing prognosis of scalp angiosarcoma.