PurposeCT myelography (CTM) and gadolinium-enhanced MR myelography (Gd-MRM) are essential methods used for localizing spinal cerebrospinal fluid leaks in patients with spontaneous intracranial hypotension (SIH) and are significant for diagnosis and guided epidural blood patches. This paper analyzes the rate and imaging features of unsuccessful myelography due to misinjection of contrast into epidural space to guide prompt and correct clinical judgment of unsuccessful myelography.Materials and Methods Myelography from 121 patients with SIH was retrospectively reviewed and the image features of the unsuccessful myelography were analyzed.Results A total of 128 myelography examinations were done. Contrast media was accidently injected into the epidural space in 33 examinations. The failure rate was 25.8%. In all 33 failed exams, bilateral spinal nerve roots on both sides of the dural sac passing through contrast media was observed without visualization of anterior and posterior nerve roots. Cauda equina was not seen within contrast media in 29 cases (87.9%); non-diffusion of contrast media into cisterns and ventricles in 26 cases (78.8%). Contrast was not continuous in spinal canal in 16 cases (48.5%), heterogeneous in 10 cases (30.3%). In 4 cases (12.1%) the inner contour of contrast was not smooth.Conclusion The unsuccessful rate of myelography is relatively high in SIH patients. A prompt and correct decision could be made based on the knowledge of contrast misinjection imaging features.

Objective To investigate the relationship between autophagy in spinal dorsal horn and development of morphine tolerance in rats.Methods Twenty-four healthy male Sprague-Dawley rats,in which intrathecal (IT) catheters were successfully placed,were randomly divided into 3 groups (n =8 each):control group (group C),morphine tolerance group (group M) and morphine + rapamycin as a reinforcing agent for autophagy group (group MR).Morphine tolerance was induced with IT morphine 20 μg twice a day for 7 consecutive days.While the equal volume of normal saline was given in group C.In addition,rapamycin 2.3μg was injected intrathecally at the second injection of morphine on 3rd day lasting for 3 consecutive days in group MR.Mechanical withdrawal threshold (MWT) to yon Frey filament stimulation was measured before IT injection and 30 min after the second IT injection on 1st,3rd,5th and 7th days.The rats were sacrificed 1 h after the last MWT measurement and the L4-6 segment of the spinal cord was removed for determination of the total mammalian target of rapamycin (mTOR) and phosphorylated mTOR(p-mTOR) and autophagy marker protein LC3 Ⅱ expression in spinal dorsal horn by Western blot.The percentage of p-mTOR expression in total mTOR expression was considered as reflection of the activity.Results MWT was gradually decreased with the prolongation of time of IT injection (P ＜ 0.05).Compared with group C,MWT was significantly increased during IT injection,mTOR activity was decreased and LC3 Ⅱ expression was up-regulated in groups M and MR (P ＜ 0.05).Compared with group M,MWT was significandy increased on 3rd,5th and 7th days after IT injection,mTOR activity was decreased and LC3 Ⅱ expression was up-regulated in group MR (P ＜ 0.05).Conclusion Increased autophagy in spinal dorsal horn is the regulatory mechanism of the body during the development of morphine tolerance in rats and can delay the development of morphine tolerance.

Objective To investigate the effect of selective intracoronary stenting to the improvement of myocardial viability and left ventricular function aftcr Q-ware acute myocardial infarction. Methods 32 patients with initial Q-wave myocardial infarction underwent isoket-infusion 99Tc mMIBI SPECT imaging and blood pool radionuclide ventriculography before and after selective intracoronary Stenting. Results (1) The abnormal radioactive segments were 212 vs 108 before and after intracoronary stenting. The mean scores of abnormal segments were 16.1?3.9 vs 8.3?1.4 (P

Objective:To investigate the clinical application of indirect-bonding in orthodontics. Methods:An ordinary Chinese paste was used to bond bracket on hard plaster stone, then tranfer it to elastic plastic film. Clinic bonding could use chemical curing or light curing adhesive. Results:Twenty patients were treated with indirect bonding method. Most patients reported that the bonding is much more comfortable and less time-consuming than anticipated. Conclusion:Indirect-bonding method could be a good supplement for direct bonding method.

Objective To evaluate and compare the therapetic effectiveness among intravenous rt-PA thrombolysis, thrombolysis plus delayed intracoronary stenting and delayed intracoronary stenting for acute myocardial infarction (AMI) using 99 [KG*2/3]Tcm-MIBI myocardial SPECT imaging. Methods Ninty-five cases of AMI were divided into three groups which were the thrombolysis group (n=31), thrombolysis plus delayed stenting group (n=30) and the delayed stenting group (n=34). 99 [KG*2/3]Tcm-MIBI myocardial SPECT imaging was performed 3 weeks after thrombolysis therapy or 1 week after intracoronary stenting.The left ventricular myocardium was divided into 16 segments for evaluation. The score of myocardial 99 [KG*2/3]Tcm-MIBI uptake were analyzed semiquantitatively and the total score of myocardial 99 [KG*2/3]Tcm-MIBI uptake was calculated. Results The scores of the 3 groups were 28.4?7.5, 19.4?6.2 and 27.3?7.2 respectively. Significant difference was shown in the thrombolysis plus delayed stenting group compared with the thrombolysis and the delayed stenting group (t=7.2, t=6.9, P0.05). Conclusion 99 Tcm-MIBI myocardial SPECT imaging has been proved to be an objective parameter for evaluating the therapeutic effectiveness of the various treatments of AMI. Thrombolysis plus delayed stenting seems to be more effective than thrombolysis and delayed stenting. On the other hand, thrombolysis and delayed stenting show similar effect in the treatment of AMI in the study.

Objective To explore the diagnostic value of CT-guided percutaneous lung biopsy for pulmonary solid lesions.Methods CT-guided percutaneous lung biopsy was performed in 97 cases of pulmonary solid lesions. The lesions were 2~10 cm (mean, 4.2 cm) in diameter, and the distance to the pleura was 0~8 cm (mean, 3.4 cm). Results Confirmative diagnoses were achieved in 73 cases of lung cancer and 21 cases of benign lesions (inflammation, tuberculosis, or sarcoidosis). The diagnostic rate was 96.9% (94/97). The biopsy could not indicate the accurate diagnosis in 3 cases, 2 of which were identified as having squamous cell carcinoma by operation, and 1 of which was followed for 2 years with no changes. Postoperative complications included 8 cases of pneumothorax, 2 cases of hemothorax, and 2 cases of emptysis. Conclusions CT-guided percutaneous lung biopsy is safe and offers a high diagnostic rate, especially suitable for lesions near the pleura.

Objective To establish the high-performance liquid chromatography(HPLC)method for measuring concentrations of methotrexate(MTX)in rat lung and some other tissues through internal iliac artery infusion.Methods Fifly female Sprague-Dawley rats were included in this study.The rats were randomly assigned to two groups.Methotrexate was injected to group one through internal iliac artery,and was injected to group two through femoral vein.Blood and tissues were collected in each group at 15,30,60.90 and 120 minutes for detection of the drug concentrations with HPLC.Results The area under the concentration time curve(AUC)in rat lung,ovary and uterus in the artery group were separately(3.77±0.28),(4.40±0.40),(9.97±0.89)μg·h-1·g-1,which were significantly different from those of the vein group[(2.31±0.25),(3.91±0.19),(7.65±1.54)μg·h-1·g-1;P<0.05].The AUC in the rat plasma,heart,kidney,liver and spleen in the artery group were separately(6.13±0.53),(1.90 ±0.11),(5.32±0.89),(14.16±1.96),(0.76±0.20)μg·h-1·g-1.There were no significant differences from the vein group[(5.79±0.71),(1.64±0.29),(5.15±1.69),(14.29 ±3.47),(0.76±0.13)μg·h-1·g-1;P>0.05].Conclusions Through internal iliac artery infusion,there are higher drug concentrations in lung.uterus and ovarian compared to venous injection.The internal-arterial chemotherapy may be used to treat pulmonary metastasis of gynecological tumor.

Objective To establish a satisfactory lung metastasis model of human choriocarcinoma using severe combined immunedeficient(SCID)mice and explore the appropriate cell concentration for the model.Methods Forty SCID mice aged between 5-6 weeks were randomly difided into four groups.1×107 cells/ml ×0.1 ml.5×106 cells/ml×0.2 ml and 1×106 cells/ml×0.1 ml of human choriocarcinoma cells JEG-3 were respectively injected in SCID mice of experimental groups by lateral tail vein,the remain group was assigned to the control group.The status and weisht of mice were observed every three days.When these mice were being dying.the size and the number of the lesions of lung metastasis in every mouse were inspected with Micro CT.After Micro CT inspection,the SCID mice were executed dissected to note whether there were tumors on all organ surfaces witll naked eyes.then made pathological sections from the metastaticfoci of fresh lung tissues,and cultured primarily cells and purified cells and passaged cells isolated from the same metastastic foci.The pathological sections were observed under the microscope.The special antigen human chorionic gonadotropin-beta subunit(β-hCG)of the choriocareinoma cells was immunohistochemically detected in the pathological sections and the cells out of cultured primarily cells.The chromosomes of the cells out of cultured primarily cells were analysed.Results Of the group inoeutated 1×107 cells/ml×0.1 ml.all mice died when inoculating.In the group of 5×106 cells/ml×0.2 ml,when inoculating, 3 mice died; the remain 7 mice were being dying on ( 18. 0 ±2. 0) days after injection. 5 of them, there were 1 - 3 lesions of lung metastasis after Micro CT inspection in each mice, and the diameter of the tumors lesions reached 1.5 - 3.5 ram, which was choriocarcinoma confirmed by pathological sections.The special antigen β-hCG was detected by immunohistoehemical method in the pathological sections of pulmonary tissue with tumor and in the cells, which were purified and passaged from being cultured primarily cells isolated from metastastic foci of fresh lung tissues from the SCID mice. The chromosome numbers of these cells out of cultured primarily ceils were variety from 19 to 128, and medal numbers were variety from 70 to 79. Conclusions We successfully established the lung metastatic model of human choriocarcinoma in SCID mice by injecting JEG-3 cells into lateral tail vein, of which 5 × 106 cells/ml × 0. 2 ml is the suitable concentration and volume for the model.

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Objective To investigate the distribution of moderate to severe cancer pain and administrated dose of opioid drugs in order to provide the reference for the treatment of moderate and severe cancer pain.Methods Retrospective analyzed the clinical data of 146 patients with moderate to severe cancer pain.The information were recorded including opioid use dose,cancer pain incidence,age,gender,height,weight,body surface area and type of tumor.Results There were no significant difference among patients with opioids drug administration in terms of gender,average daily oral dose(x2 =0.473,Z =-0.185,P ＞ 0.05).Meanwhile cancer incidence rate was same in different age groups (x2 =2.280,P =0.684).The average daily opioid dose in patients with over 80 year old was the lowest among other age groups (Z =-2.745,-1.986,-2.141,-2.162;P ＜0.05).Cancer pain incidence in patients with hepatobiliary pancreatic tumors were 67.50％ (27/40),highest than other different types cancer including metastatic tumor(62.50％ (10/16)),urinary tumor (61.54％ (8/13)),lung cancer (52.63％ (50/95)),breast cancer and gynecological tumor (50.00％ (17/34)),gastrointestinal tumor(41.94％ (26/62)),other tumors 38.46％ (5/13) and head and neck tumor(25.00％ (3/12)),the difference was statistically significant (x2 =23.672,P ＜ 0.05).The average day oral morphine dose of different types tumor were listed as followed from high to low in the order:160 (80,200) mg of metastatic tumors,120 (60,160) mg of breast and gynecological tumor,100 (40,125) mg of lung cancer,90(45,115) mg of urinary tract tumors,80(60,160) mg of other tumors,70(50,90) mg of hepatobiliary pancreatic tumor,60 (40,80) mg of gastrointestinal tumor,55 (40,70) mg of head and neck tumor.There were significant differences in terms of among oral morphine dose per day of different type tumors (H=14.280,P ＜0.05).No correlation was found between pain patients with height,body mass,body surface area and average daily dose of morphine (r =-0.045,-0.042,-0.046 ; P ＜ 0.05).Conclusion No significant differences were found in terms of moderate to severe cancer pain among different type tumors at different and age groups.While there is significant difference in term of cancer pain incidence among different tumor types.The average daily amount of morphine in patients with cancer pain is not related to gender,height,body mass and body surface area.The average amount of morphine of patients with age over 80 years old is significantly lower than that of the other age groups,and the average amount of morphine t is related to cancer type.