Objective To assess the initial clinical effect of combined endovascular and extravascular neurointerventional technique for treatment of acutely ruptured cerebral aneurysms.Methods Forty patients with acutely ruptured aneurysms were embolized with Guglielmi detachable coil (GDC) or Dendron electrically detachable coil (EDC) firstly. Immediately after the embolization, all patients were received lumbar puncture and over-the-wire microcatheters were catheterized into cisterna magna via the spinal subarachnoid space. Urokinase(100,000 IU in 2mL normal saline) was injected into cisterna magna via the microcatheter to dissolve clot 2 hours later. Urokinase injection was repeated according to the CT results. Results All the procedures of aneurysm embolization and catheterization of cisterna magna were successful, no technical complications were found. In all patients, CT scans of the day 3th to day 7th revealed complete disappearance of clot in basal cistern. One patient experienced transient sympotomatic cerebral vasospasm without permanent neurologic deficit. The other 39 patients didn't manifest symptomatic cerebral vasospasm. No aneurysmal rebleeding was detected. Conclusions Combined endovascular and extravascular neurointerventional technique can obliterate acutely ruptured cerebral aneurysms and remove the clot of basal cistern. It can prevent aneurysm rebleeding and cerebral vasospasm. Therefore it is a minimally invasive, safe and reasonable method for treatment of acutely ruptured cerebral aneurysms.

Objective To determine the accuracy of multi-slice CT pneumocolon in the staging of colonic carcinomas.Methods Thirty-six patients, who were strongly suspected to have colonic disorders, underwent CT pneumocolon before and after intravenous injection of iodinated contrast agent. CTVE, MPR, SSD, and Raysum images were then obtained by using 4 different softwares in workstation (ADW3.1). 33 positive cases were staged preoperatively according to TNM standard. All cases were proved by surgical or colonoscopic histology. Sensitivity and accuracy of MSCT were determined for the detection of cancers, lymph nodes, and metastases. Results MSCT pneumocolon examinations demonstrated 32 lesions, missing one case. Sensitivity and positive accuracy value for T staging were 96.97% (32/33) and 87.88% (29/33), respectively; Sensitivity and positive accuracy value for lymph node involvement were 73.91% (17/23) and 69.57% (16/23), respectively. The density of metastatic lymph node was higher than that of normal one. Five cases in M stage were all diagnosed correctly.Conclusion MSCT pneumocolon is a better method of depicting the colorectal carcinoma. It allows for accurate staging of the colorectal carcinoma, especially detecting the invasion of adjacent tissues and distant metastasis. However the value for early T staging in colorectal carcinoma and minute metastasis of lymph nodes is limited. It is helpful to combine all the findings of lymph nodes, including the size, density, and location, to make a correct diagnosis.

ObjectiveTo study the metastructure volumes of medial temporal lobe in diagnosis the patients with Alzheimer's disease (AD) using 3 dimensional MRI.Methods23 AD patients according to DSM-Ⅳ criteria and 23 normal controls (NC) were examined with 3D-MRI.Hippocampus formation,amygdala,entorhinal cortex ( EC ),perirhinal cortex ( PC),and comu temporale were measured with 3D-MRI.ResultsSensitivity and specificity of diagnosis AD were 73.9％,97％ ( Hippocampus formation) ;39.1％,95.7％ (amygdala) ;73.9％,95.7％ (EC) ;95.7％,87.0％ (PC) and 34.8％,39.1％ ( cornu temporale).Overall discriminate function =cornu temporal × 3.887 + PC × 5.960 - EC × 0.074 + amygdale × 3.489 + hippocampus formation × 6.656- 22.449.Over-all-accuracy was 91.3％.ConclusionThe total volume of PC can better diagnosis the mild to moderate AD than other structure of medial temporal lobe.The changes of the medial temporal lobe volume could be used in diagnosis the patients with Alzheimer's disease.

Objective To compare 1HMRS and DTI findings of Alzheimer disease (AD) patients and normal elderly controls. Methods Fifteen mild AD patients, 20 moderate to severe AD patients and 20 aging controlled normal subjects (CN) were recruited. MRS imaging and DTI were performed on a 1.5 T MRI scanner. A ROI was positioned in the posterior part of the cingulate. MRS data were processed and the metabolite ratios were estimated, including the ratios of NAA/Cr, Cho/Cr, mI/Cr. Comparing with the axial MRS location, we chose the same level to posit the ROIs on both sides of the posterior cingulated fibers on fractional anisotropy map (FA) and mean diffusivity map (MD). Mean spectroscopy data and DTI values for each groups were analysed with Mann-Whitney U non parametric test. Correlations between MRS and DTI values for AD groups were estimated using partial correlations test controlling for the age related bias. Results Compared to normal aging groups, mild AD group showed a significantly lower FA value in the left side of posterior cingulum bundle (0. 549±0. 056 vs 0. 517±0. 058,Z =2. 014,P <0. 05). Whereas, moderate to severe group versus mild AD group revealed significantly elevated MI) value and a decrease in FA value in the right side of posterior cingulate ( FA 0. 517 ± 0. 059 vs 0. 432 ± 0. 073, Z = 3. 216, P < 0. 01 ; MD (0.726±0.041) × 10-3 mm2/s vs (0.761±0.057) × 10-3 mm2/s,Z = 1.970,P <0.05) . Obvious increasing mI/Cr ratio was found in mild AD group ( 0. 61 ± 0. 07 vs 0. 68 ± 0. 12, Z = 2. 911, P < 0. 01 ). NAA/Cr ratio showed gradually decrease in AD groups. Partial correlations analysis revealed a positive correlation between ml/Cr ratio and left posterior cingulated FA value in mild AD group ( r = 0. 586, P < 0. 05) and negative correlation between NAA/Cr and MD value in the right side of posterior cingulated region ( r = - 0. 505, P < 0. 05 ). Conclusions These findings suggested that there were different regional and temporal pattern in different course of AD disease, resulting from axonal loss or gliosis. Combining MRS with DTI alternations could be a better potential indicator and could better explain the pathological changes in AD progression.

Objective To investigate changes of the interhemispheric coordination integrity in patients with hemi-parkinsonism using resting-state functional magnetic resonance imaging(rs-fMRI) homotopy technique called voxel-mirrored homotopic connectivity(VMHC).Methods Sixteen Parkinson disease(PD) patients with right body side motor symptom onset(RPD),15 patients with left side onset(LPD),and 19 age-,gender-,and education-matched healthy controls(HC) were included in this study.rs-fMRI scanning and pre-processed the raw data were performed.Then by using analysis of variance(ANOVA) and two sample t tset,we performed VMHC analyses on rs-fMRI data of these participants(P＜0.05,corrected with AlphaSim,clusters≥16 voxels).Exploratory linear correlations analyses were performed between the VMHC of regions showing significant group differences and the clinical features of LPD or RPD patients.Results Compared with HCs,patients with LPD had significantly reduced VMHC in visual regions,sensorimotor regions,and the cerebellar cortex(voxels size of 17-77,t=-5.06--3.42,P＜0.05).Patients with RPD exhibited decreased VMHC in the prefrontal cortex and sensorimotor regions.Both LPD and RPD groups had increased VMHC in subcortical regions.When compared with the RPD group,the LPD group displayed decreased VMHC in the visual regions,sensorimotor regions(voxels=16 and 18; t=-3.68and-3.87,respectively,both P＜0.05) and increased VMHC in the supramarginal gyrus(voxels=4,t=4.72,P＜0.05);ROI-based correlation analyses indicated that the VMHC in the inferior occipital gyrus and the postcentral gyrus was negatively correlated with the BDI-Ⅱ scores in the LPD group(r=-0.58 and-0.59,respectively; both P＜0.05),and positively correlated with the MMSE scores(r=0.56 and 0.52,respectively;both P＜0.05).In the RPD group,a positive correlation was found for the VMHC in the supramarginal gyrus and the illness duration(r=0.56,P＜0.05) and for the VMHC in the postcentral gyrus and the(mini-mental state exam) MMSE(r=0.53,P＜0.05).Conclusions The differential pattern of deficits in the interhemispheric coordination integrity in hemi-parkinsonism reflected by VMHC may provide insights into the neurological pathophysiology underlying the asymmetry of symptom appearance in PD.

Objective To investigate the predictive value of class Ⅲ β-tubulin protein expression in tumor tissue for the efficacy of taxol combined chemotherapy in stage Ⅲ s/Ⅳ gastric carcinoma patients.Methods Tumor biopsy samples were obtained and class Ⅲ β-tubulin protein expression were examined by immunohistochemical staining before chemotherapy.According to different expression of class Ⅲ β-tubulin,the patients were divided into two groups,group A(low expression of class Ⅲ β-tubulin),group B(high expression of class Ⅲ β-tubulin).The patients were assigned to be received 4 to 6 cycles of Taxol and S-1 chemotherapy regimens and followed up until death or lost.Response rate(RR),overall survival(OS)and time to tumor progression(TTP)were assessed.Results There was no significant difference in clinical characteristics among patients with different expression rate.The RR was higher and TIP was longer in group A than in group B(53.3 ％ vs 36.7 ％,198 days vs 146 days,P ＜ 0.05 respectively),and no significant differences of OS in two groups(P ＞ 0.05).Conclusion The expression level of class Ⅲ β-tubulin in tumor tissue is probably a predictor for the efficacy of taxol in gastric cancer patients,taxol combined chemotherapy is more suitable for patients with lower expression of class Ⅲ β-tubulin.

A novel avian influenza A (H7N9) virus recently emerged in the Yangtze River delta and caused diseases, often severe, in over 130 people. This H7N9 virus appeared to infect humans with greater ease than previous avian inlfuenza virus subtypes such as H5N1 and H9N2. While there are other potential explanations for this large number of human infections with an avian influenza virus, we investigated whether a lack of conserved T-cell epitopes between endemic H1N1 and H3N2 inlfuenza viruses and the novel H7N9 virus contributes to this observation. Here we demonstrate that a number of T cell epitopes are conserved between endemic H1N1 and H3N2 viruses and H7N9 virus. Most of these conserved epitopes are from viral internal proteins. The extent of conservation between endemic human seasonal inlfuenza and avian inlfuenza H7N9 was comparable to that with the highly pathogenic avian inlfuenza H5N1. Thus, the ease of inter-species transmission of H7N9 viruses (compared with avian H5N1 viruses) cannot be attributed to the lack of conservation of such T cell epitopes. On the contrary, our ifndings predict signiifcant T-cell based cross-reactions in the human population to the novel H7N9 virus. Our findings also have implications for H7N9 virus vaccine design.

Objective To explore the incidence and associated factors of aortic artery calcification (AAC) by lateral lumbar X-ray score in maintenance hemodialysis (MHD) patients.Mehtods A total of 155 MHD patients with complete clinical data in our hospital were enrolled in the study.Lateral lumbar X-ray score of the abdominal aorta was used to determine AAC in MHD patients.Results Aortic calcification was most severe in front of the fourth lumbar segment and ameliorated in higher lumbar levels.63.63％ of MHD patients presented visible calcification in the abdominal aorta,and 28.39％ had severe calcification with more than three segments.Age (OR=1.094,P＜0.01),dialysis vintage (OR=1.013,P=0.022),triglyceride (OR=1.261,P=0.030) and phosphate level (OR=1.324,P=0.023) were risk factors of abdominal aorta calcification,however serum albumin level (OR =0.239,P=0.013) was protect factor of aortic calcification.Conclusions Incidence of AAC is quite high in MHD patients and associated with increasing of age,duration of hemodialysis,serum triglyceride,phosphate level and plasma albumin.The semi-quantitative X-ray method of determining vascular calcification is less expensive and may be widely available clinically.

OBJECTIVE: To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. MATERIALS AND METHODS: A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. RESULTS: The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p = 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). CONCLUSION: The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.
Adult ; Aged ; Female ; Humans ; Lymphatic Metastasis ; Male ; Microcirculation ; Middle Aged ; Prognosis ; Prospective Studies ; Regional Blood Flow ; Stomach Neoplasms/*blood supply/pathology/*radiography ; *Tomography, X-Ray Computed

Objective To assess the volumetric variation of liver and spleen in early diagnosis of liver fibrosis and cirrhosis.Methods One hundred and thirty-seven subjects underwent dynamic enhanced examination of liver and spleen using multi-slice CT(MSCT).Forty potential living liver donors were served as controls.Sixty-three histologically proved fibrotic patients were divided into slight liver fibrosis(F≤2,n=44)and advanced liver fibrosis(F≥3,n=19)according to the Ishak system.Liver cirrhosis group consisted of 34 patients diagnosed clinically and radiologically.The measurement of total liver volume(TLV),right liver lobe volume(RV),left lateral liver segment volume(LLV),left medial liver segment volume(LMV),eaudate lobe volume(CV)and spleen volume(SV)were obtained bv MSCT.The ratios of segmental liver and SV to TLV were also calculated.Results The values of liver volumes(TLV,RV and LMV)reduced gradually among control(1470.38 cm3,933.34 cm3,216.20 cm3,respectively),slight liver fibrosis(1239.99 cm3,799.74 cm3,184.69 cm3,respectively),advanced liver fibrosis(1219.76 cm3,765.22 cm3,179.44 cm3,respectively)and cirrhosis(1078.21 cm3,543.73 cm3,163.12 cm3,respectively) groups.The volume of SV and the ratios of CV/TLV and SV/TLV increased gradually among control (256.29 cm3,3.09%,17.53%),slight liver fibrosis(284.41 cm3,3.20%,22.91%),advanced liver fibrosis(343.13 cm3,3.58%,28.80%)and cirrhosis(863.38 cm3,4.16%,82.91%)groups.There was significant difference among control,liver fibrosis and cirrhosis group in TLV,RV,LMV and SV/TLV(P＜0.05),but there was no significant difference in all parameters between the slight liver fibrosis group and the advanced liver fibrosis group(P＞0.05).There was significant correlation of TLV,LMV,SV,RV,CV/TLV,SV/TLV,RV/TLV and LLV/TLV with liver cirrhosis and its staging.Conclusion Variations in liver and spleen volume,the ratios of segmental liver and SV/TLV are correlated with the extent of liver fibrosis and cirrhosis.which will be helpful in early detection of liver fibrosis and cirrhosis.